Observational studyAddiction (Abingdon, England)2019
Treatment-resistant depression as risk factor for substance use disorders-a nation-wide register-based cohort study.
Observational study in Addiction (Abingdon, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 38 citations in OpenAlex.
- Extended-Release Trazodone in Comorbid Major Depressive and Sedative-Hypnotic/Anxiolytic Use Disorders: A Real-World Preliminary Evaluation of Multidimensional Outcomes.Journal of clinical medicine · 2026Article
- Psychedelics in treatment-resistant depression: a comprehensive review of mechanisms, clinical evidence, and recommendations.Neuropsychiatrie : Klinik, Diagnostik, Therapie und Rehabilitation : Organ der Gesellschaft Osterreichischer Nervenarzte und Psychiater · 2026Review
- Psychiatric outcomes and long-term school and work-related disability in offspring of parents with depression and treatment-resistant depression.Social psychiatry and psychiatric epidemiology · 2026Article
- Review
- Predicting the need for electroconvulsive therapy via machine learning trained on electronic health record data.Acta neuropsychiatrica · 2026Article
- Treatment resistant depression: Socio-demographic characteristics, comorbidity and treatment patterns from the All of Us Research Program.Journal of affective disorders · 2025Article
- Drug Addiction in Gay and Bisexual Men Living with HIV Engaged in Sexualized Drug Use: Recent Drug Use, Polydrug and Depressive Symptoms as Predictors.AIDS and behavior · 2025Article
- Substance Use-Related Factors and Recurrent Depression among Former Adolescent Psychiatric Inpatients.European addiction research · 2025Article
- Obsessive-compulsive disorder, major depressive disorder, and addiction: the vicious relationship.European journal of translational myology · 2024Article
- Intravenous ketamine for benzodiazepine deprescription and withdrawal management in treatment-resistant depression: a preliminary report.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2023Article
- Body mass index and inflammation in depression and treatment-resistant depression: a Mendelian randomisation study.BMC medicine · 2023Article
- Caring for youth with co-occurring substance use and severe psychiatric disorders: diagnostic challenges and clinical implications.Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent · 2023Article
- Population-based real-world registry study to evaluate clinical outcomes of chronic graft-versus-host disease.PloS one · 2023Article
- Healthcare utilization, costs, and productivity losses in treatment-resistant depression in Finland - a matched cohort study.BMC psychiatry · 2022Article
- REL-1017 (esmethadone; D-methadone) does not cause reinforcing effect, physical dependence and withdrawal signs in Sprague Dawley rats.Scientific reports · 2022Article
- Sex Differences in Responses to Antidepressant Augmentations in Treatment-Resistant Depression.The international journal of neuropsychopharmacology · 2022Review
- Comparisons of psychological distress and self-stigma among three types of substance use disorders receiving treatment-as-usual approaches: real-world data from a 9-month longitudinal study.Therapeutic advances in chronic disease · 2022Article
- QT interval is correlated with and can predict the comorbidity of depression and anxiety: A cross-sectional study on outpatients with first-episode depression.Frontiers in cardiovascular medicine · 2022Article
- Real-world study of direct medical and indirect costs and time spent in healthcare in patients with chronic graft versus host disease.The European journal of health economics : HEPAC : health economics in prevention and care · 2021Article
- Excess deaths in treatment-resistant depression.Therapeutic advances in psychopharmacology · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
aimsTreatment-resistant depression (TRD) is common among patients with major depressive disorder (MDD). MDD may increase the risk for developing substance use disorders (SUD). The aim of this study was to investigate the risk for developing SUD among patients with TRD compared with other depressed patients.
designObservational cohort study.
settingNation-wide governmental health registers in Sweden.
participantsAll patients aged 18-69 years with an MDD diagnosis in specialized health care who had received at least one antidepressant prescription during 2006-14 were identified. Patients with at least three treatment trials within a single depressive episode were classified with TRD. MEASUREMENTS: Patients with TRD were compared with the whole MDD cohort regarding risk for obtaining a SUD diagnosis or medication using survival analyses adjusted for socio-demographics and comorbidities.
findingsOf 121 669 MDD patients, 13% were classified with TRD. Among the patients without any history of SUD, patients with TRD had a risk increase for any SUD both ≤ 1 and > 1 year after antidepressant initiation [> 1 year hazard ratio (HR) = 1.4; 95% confidence interval (CI) = 1.3-1.5]. Risks were elevated for the subcategories of opioid (HR = 1.9, 95% CI = 1.4-2.5) and sedative SUD (HR = 2.7, 95% CI = 2.2-3.2). Patients with a history of SUD had a risk increase for any SUD ≤ 1 year after start of treatment (HR = 1.2, 95% CI = 1.1-1.4), and both ≤ 1 year and > 1 year for sedative (> 1 year HR = 2.0, 95% CI = 1.3-3.0) and multiple substance SUD (HR = 1.9, 95% CI = 1.4-2.5).
conclusionsPatients with treatment-resistant depression may be at greater risk for substance use disorders compared with other patients with major depressive disorder. Patterns may differ for patients with and without a history of substance use disorders, and for different categories of substance use disorder.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.