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Functioning and interpersonal relationships as predictors of response in treatment-resistant depression
Authors:Papakostas George I  Petersen Timothy  Mischoulon David  Hughes Megan E  Spector Andrew R  Alpert Jonathan E  Fava Maurizio  Nierenberg Andrew A
Institution:Depression Clinical and Research Program, Massachusetts General Hospital, Boston, MA, USA.
Abstract:The purpose of this study was to examine whether occupational functioning or the quality of interpersonal relationships is predictive of clinical response to a 6-week open trial of nortriptyline (NT) in patients with treatment-resistant depression (TRD). Ninety-two subjects with TRD were treated openly with NT for 6 weeks. The longitudinal interval follow-up evaluation (LIFE) scale was administered at baseline. A logistic regression was performed using occupational functioning and interpersonal relationships (over the past month and over the past 5 years) as predictors of treatment response. Unpaired t tests were performed to examine mean composite LIFE score values between responders and nonresponders. The composite scores that were statistically significant were used as single predictors of treatment status in separate logistic regression equations. Better occupational function over the past 5 years predicted better response to treatment with NT in patients with TRD. Beyond a history of nonresponse to antidepressants, long-term occupational function may be a predictor of outcome in the treatment of TRD.
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