Multiple secondary data analyses of TORDIA have identified important predictors of treatment response and relapse .
To up date a comparative effectiveness review ( 1980–2011 ) of treatments for adolescents whose depressive episode or disorder ( MDE/MDD ) did not respond to one or more trials of SSRI antidepressants .
Do sub-syndromal manic symptoms influence outcome in treatment resistant depression in adolescents? A latent class analysis from the TORDIA study.
BACKGROUND To identify distinct depressive symptom trajectories in the TORDIA study and determine their correlates . METHODS Latent Class Growth Analysis ( LCGA ) using the Children 's Depression Rating Scale-Revised ( CDRS-R ) through 72 weeks from intake . RESULTS 3 classes were identified : ( 1 ) little change in symptomatic status ( " NO " ) , comprising 24.9 % of participants , with a 72-week remission rate of 25.3 % ; ( 2 ) slow , steady improvement ( " SLOW " ) , comprising 47.9 % of participants , with a remission rate of 60.0 % , and ( 3 ) rapid symptom response ( " GO " ) , comprising 27.2 % of participants , with a remission rate of 85.7 % . Higher baseline CDRS-R ( p<0.001 ) and poorer functioning ( p=0.03 ) were the strongest discriminators between NO and GO . Higher baseline CDRS ( p<0.001 ) and scores on the Mania Rating Scale ( MRS ) ( p=0.01 ) were the strongest discriminators between SLOW and GO . Other variables differentiating GO from both NO and from SLOW , were better baseline functioning , lower hopelessness , and lower family conflict . Both NO and SLOW showed increases on the MRS over time compared to GO ( ps ≤ 0.04 ) , and increasing MRS was strongly associated with lack of remission by 72 weeks ( p=0.02 ) . LIMITATIONS High rate of open treatment by the end of the follow-up period creates difficulty in drawing clear inferences about the long-term impact of initial r and omization . CONCLUSION Along with depressive severity , sub-syndromal manic symptoms , at baseline , and over time emerged as important predictors and correlates of poor outcome in this sample . Further research is needed on the treatment of severe depression , and on the assessment and management of sub-syndromal manic symptoms in treatment resistant depression
Multiple secondary data analyses of TORDIA have identified important predictors of treatment response and relapse .
To up date a comparative effectiveness review ( 1980–2011 ) of treatments for adolescents whose depressive episode or disorder ( MDE/MDD ) did not respond to one or more trials of SSRI antidepressants .