This randomized trial compares the efficacy of targeted complicated grief treatment, citalopram, both, or neither on the outcomes of patients with complicated grief.
This meta-analysis examines individual patient data to discover the efficacy of mindfulness-based cognitive therapy compared with usual care and other active treatments, including antidepressants, in treating those with recurrent depression.
This study uses civil and psychiatric national registers to evaluate patterns and correlates in 10-year trajectories associated with the diagnosis of major depressive disorder in a Danish population.
This randomized clinical trial compares the efficacy of light treatment, both as monotherapy and in combination with fluoxetine, with a sham placebo condition for adults with nonseasonal major depressive disorder.
This randomized clinical trial compares the efficacy of cognitive behavioral group psychotherapy vs individual clinical management and methylphenidate vs placebo in patients with adult attention-deficit/hyperactivity disorder.
This cohort study examines rates of chronic kidney disease in relation to use of lithium, anticonvulsants, and other drugs for treatment of bipolar disorder.
This meta-analysis examines baseline depression severity as a moderator of treatment outcomes between cognitive behavioral therapy and antidepressant medication.
This placebo trial examines the neurochemical mechanisms underlying the formation of placebo effects in patients with major depressive disorder.
This randomized clinical trial determines whether a cognitive-behavioral prevention program can reduce the incidence of depressive episodes, increase depression-free days, and improve developmental competence 6 years after implementation among at-risk adolescents.
This randomized clinical trial examines the effects of telephone-delivered cognitive-behavioral therapy compared with telephone-delivered nondirective supportive therapy in rural older adults with generalized anxiety disorder.
This open-label pharmacological trial uses group-based trajectory modeling to assess patterns of response to extended-release venlafaxine for late-life depression in older adults and the clinical factors associated with these patterns.
This 12-week, double-blind, randomized clinical trial of naltrexone vs placebo in individuals with alcohol dependence does not support the hypothesis that the Asp40 allele moderates the response to naltrexone treatment.
This multisite, randomized clinical trial finds that venlafaxine XR was well tolerated by most patients and an effective antidepressant for decreasing core symptoms of depression and improving spinal cord injury–related disability.
It has been suggested that patients with major depressive disorder (MDD) who display pretreatment features suggestive of bipolar disorder or bipolar spectrum features might have poorer treatment outcomes.
To assess the association between bipolar spectrum features and antidepressant treatment outcome in MDD.
Open treatment followed by sequential randomized controlled trials.
Primary and specialty psychiatric outpatient centers in the United States.
Male and female outpatients aged 18 to 75 years with a DSM-IV diagnosis of nonpsychotic MDD who participated in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study.
Open treatment with citalopram followed by up to 3 sequential next-step treatments.
Number of treatment levels required to reach protocol-defined remission, as well as failure to return for the postbaseline visit, loss to follow-up, and psychiatric adverse events. For this secondary analysis, putative bipolar spectrum features, including items on the mania and psychosis subscales of the Psychiatric Diagnosis Screening Questionnaire, were examined for association with treatment outcomes.
Of the 4041 subjects who entered the study, 1198 (30.0%) endorsed at least 1 item on the psychosis scale and 1524 (38.1%) described at least 1 recent maniclike/hypomaniclike symptom. Irritability and psychoticlike symptoms at entry were significantly associated with poorer outcomes across up to 4 treatment levels, as were shorter episodes and some neurovegetative symptoms of depression. However, other indicators of bipolar diathesis including recent maniclike symptoms and family history of bipolar disorder as well as summary measures of bipolar spectrum features were not associated with treatment resistance.
Self-reported psychoticlike symptoms were common in a community sample of outpatients with MDD and strongly associated with poorer outcomes. Overall, the data do not support the hypothesis that unrecognized bipolar spectrum illness contributes substantially to antidepressant treatment resistance.