Anhedonia predicts poorer recovery among youth with selective serotonin reuptake inhibitor treatment-resistant depression
Dana L McMakin, Thomas M Olino, Giovanna Porta, Laura J Dietz, Graham Emslie, Gregory Clarke, Karen Dineen Wagner, Joan R Asarnow, Neal D Ryan, Boris Birmaher, Wael Shamseddeen, Taryn Mayes, Betsy Kennard, Anthony Spirito, Martin Keller, Frances L Lynch, John F Dickerson, David A Brent, Dana L McMakin, Thomas M Olino, Giovanna Porta, Laura J Dietz, Graham Emslie, Gregory Clarke, Karen Dineen Wagner, Joan R Asarnow, Neal D Ryan, Boris Birmaher, Wael Shamseddeen, Taryn Mayes, Betsy Kennard, Anthony Spirito, Martin Keller, Frances L Lynch, John F Dickerson, David A Brent
Abstract
Objective: To identify symptom dimensions of depression that predict recovery among selective serotonin reuptake inhibitor (SSRI) treatment-resistant adolescents undergoing second-step treatment.
Method: The Treatment of Resistant Depression in Adolescents (TORDIA) trial included 334 SSRI treatment-resistant youth randomized to a medication switch, or a medication switch plus CBT. This study examined five established symptom dimensions (Child Depression Rating Scale-Revised) at baseline as they predicted recovery over 24 weeks of acute and continuation treatment. The two indices of recovery that were evaluated were time to remission and number of depression-free days.
Results: Multivariate analyses examining all five depression symptom dimensions simultaneously indicated that anhedonia was the only dimension to predict a longer time to remission, and also the only dimension to predict fewer depression-free days. In addition, when anhedonia and CDRS-total score were evaluated simultaneously, anhedonia continued to uniquely predict longer time to remission and fewer depression-free days.
Conclusions: Anhedonia may represent an important negative prognostic indicator among treatment-resistant depressed adolescents. Further research is needed to elucidate neurobehavioral underpinnings of anhedonia, and to test treatments that target anhedonia in the context of overall treatment of depression.
Trial registration: ClinicalTrials.gov NCT00018902.
Copyright © 2012 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.
Source: PubMed