Patients with treatment-resistant depression are at higher risk of early death

Patients with treatment-resistant depression are at higher risk of early death

Washington [US], Dec 15 (ANI): Patients with treatment-resistant depression have a 23 percent higher risk of dying than other depressed patients. They also have twice as much outpatient care and spend three times as many days in inpatient care. That’s according to a new study published in JAMA Psychiatry by researchers from Karolinska Institutet and elsewhere, which concludes that it is crucial to identify patients who are at risk of developing treatment-resistant depression.

Depression is the most common cause of disability worldwide. The most common treatments are antidepressants or psychotherapy. Many sufferers need care for months or years, but a significant proportion of patients never recover despite two well-executed treatment attempts. They have what is usually called treatment-resistant depression.

Researchers at the Karolinska Institutet and the Center for Psychiatry Research have now investigated the effects of treatment-resistant depression in the Stockholm Region on both an individual and societal level, something that has not been studied to the same extent before.

In the population-based observational study, the researchers used data from several sources, including Region Stockholm’s administrative healthcare database and the Swedish Social Insurance Agency. Over 145,000 patients with depression in the Stockholm region were included in the study.

After identifying 158,000 depressive episodes in these patients between 2012 and 2017, of which over 12,000 were of a treatment-resistant nature, the researchers were able to draw a number of conclusions about what characterizes patients with treatment-resistant depression.

“We found that the treatment-resistant group used twice as much outpatient resources, had twice as much sick leave, spent three times the number of days in the hospital, and had a 23 percent higher mortality rate than patients with treatment-sensitive depression.” says Johan Lundberg, adjunct professor of psychiatry at the department of clinical neuroscience and head of the section for mood disorders at Norra Stockholm’s psychiatry clinic.

They also found increased comorbidity with other psychiatric conditions, such as anxiety disorders, insomnia, substance abuse disorders, and self-harm in the group with treatment-resistant depression.

The researchers discovered that the risk of developing treatment-resistant depression could be predicted already at the first depression diagnosis. By far the most important prognostic factor was self-rated severity of depression.

– We would benefit from identifying patients who are at risk of developing treatment-resistant depression, because it causes a lot of personal suffering and is a burden on the whole society, says Professor Johan Lundberg.

It took an average of a year and a half for the patients with treatment-resistant depression to complete the two treatment trials, which is several months longer than is recommended to assess the effectiveness of a treatment for depression. Professor Lundberg says that a more frequent exchange of ineffective treatments would probably be of great help to this patient group.

“We are talking about a patient group with a significant consumption of care that can be identified earlier than today by increasing the use of scales for the severity of symptoms. Based on the results of the study, their care and treatment could be improved if their doctors replaced ineffective treatments more quickly and used more frequent treatments recommended for treatment-resistant depression, such as lithium, than was the case in the study material, says Professor Lundberg.(ANI)


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