Prediction of 12-Week Remission by Psychopharmacological Treatment Step in Patients With Depressive Disorders

Abstract

Objective To investigate the predictors of remission by 4 treatment steps in depressive outpatients receiving 12-week psychopharmacotherapy.Methods Patients were consecutively recruited at a university hospital in South Korea from March 2012 to April 2017. At baseline, 1,262 patients were evaluated for sociodemographic and clinical data including assessments scales, and were received antidepressant monotherapy. For patients with an insufficient response or uncomfortable side effects, next treatment steps (1, 2, 3, and 4) with alternative strategies (switching, augmentation, combination, and mixtures of these approaches) were administered considering measurements and patient preference at every 3 weeks in the acute treatment phase (3, 6, 9, and 12 weeks). Remission was defined as a Hamilton Depression Rating Scale score of ≤7.Results In the multi-variate logistic regression analyses, remission was predicted by higher functional levels in patients received Step 1 and 2 treatment; by lower life stressors in Step 1; by higher social support in Step 3 and 4; and by lower suicidality in Step 1–3.Conclusion Differential associations were found between symptoms or functions and treatment steps, which suggested that multi-faceted evaluations at baseline could predict remission by treatment steps.