Socioeconomic Predictors of Treatment Outcomes Among Adults With Major Depressive Disorder

Jeffrey A. Mills, Vikram Suresh, Lenisa Chang, Taryn Mayes, Paul E. Croarkin, Madhukar H. Trivedi, Jeffrey R. Strawn

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE: In this study, the authors sought to examine the impact of socioeconomic variables on outcomes of pharmacotherapy treatments for major depressive disorder in analyses that controlled for treatment access and level of care. METHODS: The authors used data from the Combining Medications to Enhance Depression Outcomes study, a prospective clinical trial conducted from March 2008 to April 2014 with 665 adults who had major depressive disorder and were randomly assigned to three pharmacotherapeutic treatments, to develop Bayesian hierarchical models of treatment trajectories for change in Quick Inventory of Depressive Symptomatology-Self-Report ratings. Posterior tail probabilities were used to evaluate the effects of education, income, race-ethnicity, and employment on treatment outcomes. RESULTS: After sex, age, and treatment type were controlled for in the analyses, not having a college education (<16 years of schooling), being unemployed, or being non-White were each associated with slower and less improvement. At the end of treatment (week 12), not having a college degree reduced treatment responses by 9.6% (p=0.045), being unemployed by 6.6% (p=0.007), and being non-White by 11.3% (p<0.001). Treatment response was significantly related to income; having an income at the 25th percentile of the income distribution decreased improvement by 4.8% compared with having an income at the 75th percentile (p=0.018). CONCLUSIONS: Within a short-term, randomized controlled trial, socioeconomic factors had a critical role in the acute response of patients to pharmacotherapy for major depression.

Original languageEnglish (US)
Pages (from-to)965-969
Number of pages5
JournalPsychiatric services (Washington, D.C.)
Volume73
Issue number9
DOIs
StatePublished - Sep 1 2022
Externally publishedYes

Keywords

  • Clinical trial
  • CO-MED
  • Depression
  • Selective serotonin reuptake inhibitors
  • Socioeconomics

ASJC Scopus subject areas

  • Medicine(all)

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