Presenting characteristics of depressed outpatients as a function of recurrence: Preliminary findings from the STAR*D clinical trial

Steven D. Hollon, Richard C. Shelton, Stephen Wisniewski, Diane Warden, Melanie M. Biggs, Edward S. Friedman, Mustafa Husain, David J. Kupfer, Andrew A. Nierenberg, Timothy J. Petersen, Kathy Shores-Wilson, A. John Rush

Research output: Contribution to journalArticle

76 Citations (Scopus)

Abstract

Objectives: Recurrent depression predicts risk for subsequent episodes, but it is unclear how it relates to demographic features, course of illness, and clinical presentation. Methods: We report on the baseline data for the first 1500 patients enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (www.star-d.org). Patients were required to have a DSM-IV diagnosis of nonpsychotic major depression and to score ≥ 14 on the 17-item Hamilton rating scale for depression. Status with respect to recurrent depression and other aspects of illness course and demographic features were ascertained at intake, along with measures of depression and concurrent general medical illness. Results: Patients with recurrent depression were older, had an earlier age of onset, and were more likely to have a positive family history of depression than first episode patients. However, recurrent patients were less likely to be chronic and reported shorter current episodes than first episode patients, something that was largely confined to females. Recurrent patients were more likely than first episode patients to report non-essential aspects of mood, cognition, and somatic symptoms, although largely as a consequence of greater overall depressive symptom severity. Conclusions: As compared to single episode depressions, recurrent depression was associated with greater symptom severity and illness characteristics suggestive of greater underlying risk, but not other demographic characteristics than age. Risk for recurrence appeared to be distinct from chronic depression. A subset of chronic first episode patients may lack the capacity to remit and may therefore be distinct from those with recurrent episodes.

Original languageEnglish (US)
Pages (from-to)59-69
Number of pages11
JournalJournal of Psychiatric Research
Volume40
Issue number1
DOIs
StatePublished - Feb 2006

Fingerprint

Outpatients
Clinical Trials
Depression
Recurrence
Therapeutics
Demography
Age of Onset
Diagnostic and Statistical Manual of Mental Disorders
Cognition

Keywords

  • Chronic
  • Depression
  • Recurrent
  • Risk

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Biological Psychiatry
  • Psychology(all)

Cite this

Presenting characteristics of depressed outpatients as a function of recurrence : Preliminary findings from the STAR*D clinical trial. / Hollon, Steven D.; Shelton, Richard C.; Wisniewski, Stephen; Warden, Diane; Biggs, Melanie M.; Friedman, Edward S.; Husain, Mustafa; Kupfer, David J.; Nierenberg, Andrew A.; Petersen, Timothy J.; Shores-Wilson, Kathy; Rush, A. John.

In: Journal of Psychiatric Research, Vol. 40, No. 1, 02.2006, p. 59-69.

Research output: Contribution to journalArticle

Hollon, Steven D. ; Shelton, Richard C. ; Wisniewski, Stephen ; Warden, Diane ; Biggs, Melanie M. ; Friedman, Edward S. ; Husain, Mustafa ; Kupfer, David J. ; Nierenberg, Andrew A. ; Petersen, Timothy J. ; Shores-Wilson, Kathy ; Rush, A. John. / Presenting characteristics of depressed outpatients as a function of recurrence : Preliminary findings from the STAR*D clinical trial. In: Journal of Psychiatric Research. 2006 ; Vol. 40, No. 1. pp. 59-69.
@article{29653b64e5c54e1985f97bc7b8e08012,
title = "Presenting characteristics of depressed outpatients as a function of recurrence: Preliminary findings from the STAR*D clinical trial",
abstract = "Objectives: Recurrent depression predicts risk for subsequent episodes, but it is unclear how it relates to demographic features, course of illness, and clinical presentation. Methods: We report on the baseline data for the first 1500 patients enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (www.star-d.org). Patients were required to have a DSM-IV diagnosis of nonpsychotic major depression and to score ≥ 14 on the 17-item Hamilton rating scale for depression. Status with respect to recurrent depression and other aspects of illness course and demographic features were ascertained at intake, along with measures of depression and concurrent general medical illness. Results: Patients with recurrent depression were older, had an earlier age of onset, and were more likely to have a positive family history of depression than first episode patients. However, recurrent patients were less likely to be chronic and reported shorter current episodes than first episode patients, something that was largely confined to females. Recurrent patients were more likely than first episode patients to report non-essential aspects of mood, cognition, and somatic symptoms, although largely as a consequence of greater overall depressive symptom severity. Conclusions: As compared to single episode depressions, recurrent depression was associated with greater symptom severity and illness characteristics suggestive of greater underlying risk, but not other demographic characteristics than age. Risk for recurrence appeared to be distinct from chronic depression. A subset of chronic first episode patients may lack the capacity to remit and may therefore be distinct from those with recurrent episodes.",
keywords = "Chronic, Depression, Recurrent, Risk",
author = "Hollon, {Steven D.} and Shelton, {Richard C.} and Stephen Wisniewski and Diane Warden and Biggs, {Melanie M.} and Friedman, {Edward S.} and Mustafa Husain and Kupfer, {David J.} and Nierenberg, {Andrew A.} and Petersen, {Timothy J.} and Kathy Shores-Wilson and Rush, {A. John}",
year = "2006",
month = "2",
doi = "10.1016/j.jpsychires.2005.07.008",
language = "English (US)",
volume = "40",
pages = "59--69",
journal = "Journal of Psychiatric Research",
issn = "0022-3956",
publisher = "Elsevier Limited",
number = "1",

}

TY - JOUR

T1 - Presenting characteristics of depressed outpatients as a function of recurrence

T2 - Preliminary findings from the STAR*D clinical trial

AU - Hollon, Steven D.

AU - Shelton, Richard C.

AU - Wisniewski, Stephen

AU - Warden, Diane

AU - Biggs, Melanie M.

AU - Friedman, Edward S.

AU - Husain, Mustafa

AU - Kupfer, David J.

AU - Nierenberg, Andrew A.

AU - Petersen, Timothy J.

AU - Shores-Wilson, Kathy

AU - Rush, A. John

PY - 2006/2

Y1 - 2006/2

N2 - Objectives: Recurrent depression predicts risk for subsequent episodes, but it is unclear how it relates to demographic features, course of illness, and clinical presentation. Methods: We report on the baseline data for the first 1500 patients enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (www.star-d.org). Patients were required to have a DSM-IV diagnosis of nonpsychotic major depression and to score ≥ 14 on the 17-item Hamilton rating scale for depression. Status with respect to recurrent depression and other aspects of illness course and demographic features were ascertained at intake, along with measures of depression and concurrent general medical illness. Results: Patients with recurrent depression were older, had an earlier age of onset, and were more likely to have a positive family history of depression than first episode patients. However, recurrent patients were less likely to be chronic and reported shorter current episodes than first episode patients, something that was largely confined to females. Recurrent patients were more likely than first episode patients to report non-essential aspects of mood, cognition, and somatic symptoms, although largely as a consequence of greater overall depressive symptom severity. Conclusions: As compared to single episode depressions, recurrent depression was associated with greater symptom severity and illness characteristics suggestive of greater underlying risk, but not other demographic characteristics than age. Risk for recurrence appeared to be distinct from chronic depression. A subset of chronic first episode patients may lack the capacity to remit and may therefore be distinct from those with recurrent episodes.

AB - Objectives: Recurrent depression predicts risk for subsequent episodes, but it is unclear how it relates to demographic features, course of illness, and clinical presentation. Methods: We report on the baseline data for the first 1500 patients enrolled in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (www.star-d.org). Patients were required to have a DSM-IV diagnosis of nonpsychotic major depression and to score ≥ 14 on the 17-item Hamilton rating scale for depression. Status with respect to recurrent depression and other aspects of illness course and demographic features were ascertained at intake, along with measures of depression and concurrent general medical illness. Results: Patients with recurrent depression were older, had an earlier age of onset, and were more likely to have a positive family history of depression than first episode patients. However, recurrent patients were less likely to be chronic and reported shorter current episodes than first episode patients, something that was largely confined to females. Recurrent patients were more likely than first episode patients to report non-essential aspects of mood, cognition, and somatic symptoms, although largely as a consequence of greater overall depressive symptom severity. Conclusions: As compared to single episode depressions, recurrent depression was associated with greater symptom severity and illness characteristics suggestive of greater underlying risk, but not other demographic characteristics than age. Risk for recurrence appeared to be distinct from chronic depression. A subset of chronic first episode patients may lack the capacity to remit and may therefore be distinct from those with recurrent episodes.

KW - Chronic

KW - Depression

KW - Recurrent

KW - Risk

UR - http://www.scopus.com/inward/record.url?scp=30944436021&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=30944436021&partnerID=8YFLogxK

U2 - 10.1016/j.jpsychires.2005.07.008

DO - 10.1016/j.jpsychires.2005.07.008

M3 - Article

C2 - 16243357

AN - SCOPUS:30944436021

VL - 40

SP - 59

EP - 69

JO - Journal of Psychiatric Research

JF - Journal of Psychiatric Research

SN - 0022-3956

IS - 1

ER -