ArticleDepression and anxiety2018
Finding treatment-resistant depression in real-world data: How a data-driven approach compares with expert-based heuristics.
Article in Depression and anxiety, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
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Who cites it
23 citing papers in PubMed.
- Trial
- Impaired regional structure-function coupling as novel neurophenotype: mechanistic insights and diagnostic exploration in treatment-resistant depression.Npj mental health research · 2026Article
- Rethinking the Treatment-Resistant Depression.Advances in experimental medicine and biology · 2026Review
- Risk factors for treatment resistance among women with postpartum depression in a nationwide study.Nature. Mental health · 2026Article
- Prediction of treatment-resistant depression using the 23andMe survey data.Scientific reports · 2025Article
- Pharmaco-Multiomics: A New Frontier in Precision Psychiatry.International journal of molecular sciences · 2025Review
- Clinical associations with treatment resistance in depression: An electronic health record study.Psychiatry research · 2024Article
- Facts and myths about use of esketamine for treatment-resistant depression: a narrative clinical review.Frontiers in psychiatry · 2024Review
- Suicide-specific mortality among patients with treatment-resistant major depressive disorder, major depressive disorder with prior suicidal ideation or suicide attempts, or major depressive disorder alone.Brain and behavior · 2023Observational
- Incidence of treatment-resistant depression during the first mood depressive episode.La Tunisie medicale · 2023Article
- Differences between men and women in response to antiseizure medication use and the likelihood of developing treatment resistant epilepsy.Epilepsia open · 2022Article
- Novel drug developmental strategies for treatment-resistant depression.British journal of pharmacology · 2022Review
- Article
- At baseline patients treated with esketamine have higher burden of disease than other patients with treatment resistant depression: Learnings from a population based study.Depression and anxiety · 2021Article
- Healthcare Resource Consumption and Related Costs of Patients Estimated with Treatment-Resistant Depression in Italy.ClinicoEconomics and outcomes research : CEOR · 2021Article
- Article
- Treatment-Resistant Depression in a Real-World Setting: First Interim Analysis of Characteristics, Healthcare Resource Use, and Utility Values of the FondaMental Cohort.Brain sciences · 2020Article
- Treatment resistant depression in women with peripartum depression.BMC pregnancy and childbirth · 2019Article
- Antidepressant discontinuation in treatment resistant depression.Contemporary clinical trials communications · 2019Article
- Burden of treatment-resistant depression in Medicare: A retrospective claims database analysis.PloS one · 2019Article
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6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDepression that does not respond to antidepressants is treatment-resistant depression (TRD). TRD definitions include assessments of treatment response, dose and duration, and implementing these definitions in claims databases can be challenging. We built a data-driven TRD definition and evaluated its performance.
methodsWe included adults with depression, ≥1 antidepressant, and no diagnosis of mania, dementia, or psychosis. Subjects were stratified into those with and without proxy for TRD. Proxies for TRD were electroconvulsive therapy, deep brain, or vagus nerve stimulation. The index date for subjects with proxy for TRD was the procedure date, and for subjects without, the date of a randomly selected visit. We used three databases. We fit decision tree predictive models. We included number of distinct antidepressants, with and without adequate doses and duration, number of antipsychotics and psychotherapies, and expert-based definitions, 3, 6, and 12 months before index date. To assess performance, we calculated area under the curve (AUC) and transportability.
resultsWe analyzed 33,336 subjects with no proxy for TRD, and 3,566 with the proxy. Number of antidepressants and antipsychotics were selected in all periods. The best model was at 12 months with an AUC = 0.81. The rule transported well and states that a subject with ≥1 antipsychotic or ≥3 antidepressants in the last year has TRD. Applying this rule, 15.8% of subjects treated for depression had TRD.
conclusionThe definition that best discriminates between subjects with and without TRD considers number of distinct antidepressants (≥3) or antipsychotics (≥1) in the last year.
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