Predictors of poor 6-week outcome in a cohort of major depressive disorder patients treated with antidepressant medication: the role of entrapment
Journal article
Authors | Carvalho, Serafim, Caetano, Filipa, Pinto-Gouveia, José, Mota-Pereira, Jorge, Maia, Dulce, Pimentel, Paulo, Priscila, Cátia and Gilbert, Paul |
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Abstract | Only a small number of consistent processes predict which depressed patients will achieve remission with antidepressant medication. One set of processes is that of social ranking strategies/variables that are related to life events and severe difficulties. Particularly, defeat and entrapment predict poorer response to antidepressants. However, results are inconsistent. The current study aimed to evaluate evolutionary strategies, childhood maltreatment, neglect and life events and difficulties (LEDs) as predictors of remission in depressed patients undergoing pharmacological treatment in a psychiatric outpatient sample. A cohort of 139 depressed outpatients undergoing pharmacological treatment was followed prospectively in a naturalistic study for 6 weeks. Two major evaluations were considered at baseline and 6 weeks. We allocated patients to a pharmacological treatment algorithm for depression – the Texas Medication Algorithm Project. Variables evaluated at baseline and tested as predictors of remission included demographic and clinical data, severity of depression, social ranking, evolution informed variables, LEDs and childhood maltreatment. Of the 139 patients, only 24.5% were remitted at week 6. In univariate analyses, non-remitted patients scored significantly higher in all psychopathology and vulnerability scales except for submissive behaviour and internal entrapment. For the logistic regression, a higher load of LEDs of the entrapment and humiliation dimension in the year before the index episode (OR = 6.62), and higher levels external entrapment in the Entrapment Scale (OR = 1.10) predicted non-remission. These variables accounted for 28.7% of the variance. Multivariate analysis revealed that external entrapment was the only predictor of non-remission. |
Keywords | Psychiatry and Mental health; major depressive disorder; pharmacological treatment; childhood maltreatment; life events; entrapment; social ranking |
Year | 2020 |
Journal | Nordic Journal of Psychiatry |
Publisher | Informa UK Limited |
ISSN | 0803-9488 |
1502-4725 | |
Digital Object Identifier (DOI) | https://doi.org/10.1080/08039488.2020.1790657 |
Web address (URL) | http://hdl.handle.net/10545/625986 |
http://creativecommons.org/licenses/by-nc-nd/4.0/ | |
hdl:10545/625986 | |
Publication dates | 10 Jul 2020 |
Publication process dates | |
Deposited | 07 Sep 2021, 11:30 |
Accepted | 29 Jun 2020 |
Rights | Attribution-NonCommercial-NoDerivatives 4.0 International |
Contributors | Hospital de Magalhães Lemos, Porto, Portugal, Universidade de Coimbra, Portugal, Clínica Médico-Psiquiátrica da Ordem, Porto, Portugal, Departamento de Psiquiatria e Saúde Mental, Centro Hospitalar de Trás-os-Montes e Alto Douro, Vila Real, Portugal and University of Derby |
File | File Access Level Open |
File | File Access Level Open |
https://repository.derby.ac.uk/item/94qq7/predictors-of-poor-6-week-outcome-in-a-cohort-of-major-depressive-disorder-patients-treated-with-antidepressant-medication-the-role-of-entrapment
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