Socio-demographic and clinical risk factors of treatment-resistant depression: A Danish population-based cohort study

Frederikke Hordam Gronemann; Martin Balslev Jorgensen; Merete Nordentoft; Per Kragh Andersen; Merete Osler

doi:10.1016/j.jad.2019.10.005

Socio-demographic and clinical risk factors of treatment-resistant depression: A Danish population-based cohort study

Frederikke Hordam Gronemann, Martin Balslev Jorgensen, Merete Nordentoft, Per Kragh Andersen, Merete Osler

5 Citationer (Scopus)

Abstract

Background: Knowledge of risk factors of treatment-resistant depression (TRD) contributes to understand the underlying mechanisms and to identify patients at risk. However, there is still a lack of studies on how different risk factors associate with TRD. The objective of this study was to determine the independent association of several socio-demographic and clinical risk factors with TRD. Methods: 194.074 patients with a first-time hospital contact for depression identified in the Danish National Patient Registry (DNPR) from 1996 through 2014 were followed for TRD for 12 months after diagnosis. Socio-demographic and clinical risk factors were identified in nation-wide registries. Data were analyzed using Cox Proportional Hazard Regression and Fine-Gray model for competing mortality risk. Results: Indicators of disease severity (recurrent depression (adjusted HR (aHR) 1.17 (1.14–1.20)), severity of depression (aHR 2.01 (1.95–2.08)), admission to a psychiatric ward (aHR 2.03 (1.96, 2.10)) were strong risk factors. Aged 65–84 (aHR 1.96 (1.83–2.10)), lost labor market affiliation ((aHR 1.12 (1.08, 1.16)), cohabiting (aHR 1.27 (1.23, 1.30)), comorbid anxiety (aHR 1.18 (1.10–1.27)), insomnia (aHR 1.27 (1.06–1.51)), migraine (aHR 1.42 (1.16–1.73)) and use of psychotropic drugs was also associated with higher rates of TRD. Limitations: Information on drug use during hospitalization was not available. Information on rating scales could have provided a more precise assessment of symptom severity and treatment response. Conclusions: Besides indicators of disease severity, other important risk factors associated with TRD are age, lost labor market affiliation, cohabiting with a partner as well as anxiety, insomnia, migraine and the use of psychotropic medications.

Originalsprog	Engelsk
Tidsskrift	Journal of Affective Disorders
Vol/bind	261
Sider (fra-til)	221-229
ISSN	0165-0327
DOI	https://doi.org/10.1016/j.jad.2019.10.005
Status	Udgivet - 15 jan. 2020

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10.1016/j.jad.2019.10.005

Citationsformater

@article{36899389f87c4b289d790a3313fa3b26,

title = "Socio-demographic and clinical risk factors of treatment-resistant depression: A Danish population-based cohort study",

abstract = "Background: Knowledge of risk factors of treatment-resistant depression (TRD) contributes to understand the underlying mechanisms and to identify patients at risk. However, there is still a lack of studies on how different risk factors associate with TRD. The objective of this study was to determine the independent association of several socio-demographic and clinical risk factors with TRD. Methods: 194.074 patients with a first-time hospital contact for depression identified in the Danish National Patient Registry (DNPR) from 1996 through 2014 were followed for TRD for 12 months after diagnosis. Socio-demographic and clinical risk factors were identified in nation-wide registries. Data were analyzed using Cox Proportional Hazard Regression and Fine-Gray model for competing mortality risk. Results: Indicators of disease severity (recurrent depression (adjusted HR (aHR) 1.17 (1.14–1.20)), severity of depression (aHR 2.01 (1.95–2.08)), admission to a psychiatric ward (aHR 2.03 (1.96, 2.10)) were strong risk factors. Aged 65–84 (aHR 1.96 (1.83–2.10)), lost labor market affiliation ((aHR 1.12 (1.08, 1.16)), cohabiting (aHR 1.27 (1.23, 1.30)), comorbid anxiety (aHR 1.18 (1.10–1.27)), insomnia (aHR 1.27 (1.06–1.51)), migraine (aHR 1.42 (1.16–1.73)) and use of psychotropic drugs was also associated with higher rates of TRD. Limitations: Information on drug use during hospitalization was not available. Information on rating scales could have provided a more precise assessment of symptom severity and treatment response. Conclusions: Besides indicators of disease severity, other important risk factors associated with TRD are age, lost labor market affiliation, cohabiting with a partner as well as anxiety, insomnia, migraine and the use of psychotropic medications.",

keywords = "Treatment-resistant, Depression, Major depressive disorder, Antidepressants, Population-based study, Epidemiology",

author = "Gronemann, {Frederikke Hordam} and Jorgensen, {Martin Balslev} and Merete Nordentoft and Andersen, {Per Kragh} and Merete Osler",

year = "2020",

month = jan,

day = "15",

doi = "10.1016/j.jad.2019.10.005",

language = "English",

volume = "261",

pages = "221--229",

journal = "Journal of Affective Disorders",

issn = "0165-0327",

publisher = "Elsevier",

}

TY - JOUR

T1 - Socio-demographic and clinical risk factors of treatment-resistant depression: A Danish population-based cohort study

AU - Gronemann, Frederikke Hordam

AU - Jorgensen, Martin Balslev

AU - Nordentoft, Merete

AU - Andersen, Per Kragh

AU - Osler, Merete

PY - 2020/1/15

Y1 - 2020/1/15

N2 - Background: Knowledge of risk factors of treatment-resistant depression (TRD) contributes to understand the underlying mechanisms and to identify patients at risk. However, there is still a lack of studies on how different risk factors associate with TRD. The objective of this study was to determine the independent association of several socio-demographic and clinical risk factors with TRD. Methods: 194.074 patients with a first-time hospital contact for depression identified in the Danish National Patient Registry (DNPR) from 1996 through 2014 were followed for TRD for 12 months after diagnosis. Socio-demographic and clinical risk factors were identified in nation-wide registries. Data were analyzed using Cox Proportional Hazard Regression and Fine-Gray model for competing mortality risk. Results: Indicators of disease severity (recurrent depression (adjusted HR (aHR) 1.17 (1.14–1.20)), severity of depression (aHR 2.01 (1.95–2.08)), admission to a psychiatric ward (aHR 2.03 (1.96, 2.10)) were strong risk factors. Aged 65–84 (aHR 1.96 (1.83–2.10)), lost labor market affiliation ((aHR 1.12 (1.08, 1.16)), cohabiting (aHR 1.27 (1.23, 1.30)), comorbid anxiety (aHR 1.18 (1.10–1.27)), insomnia (aHR 1.27 (1.06–1.51)), migraine (aHR 1.42 (1.16–1.73)) and use of psychotropic drugs was also associated with higher rates of TRD. Limitations: Information on drug use during hospitalization was not available. Information on rating scales could have provided a more precise assessment of symptom severity and treatment response. Conclusions: Besides indicators of disease severity, other important risk factors associated with TRD are age, lost labor market affiliation, cohabiting with a partner as well as anxiety, insomnia, migraine and the use of psychotropic medications.

AB - Background: Knowledge of risk factors of treatment-resistant depression (TRD) contributes to understand the underlying mechanisms and to identify patients at risk. However, there is still a lack of studies on how different risk factors associate with TRD. The objective of this study was to determine the independent association of several socio-demographic and clinical risk factors with TRD. Methods: 194.074 patients with a first-time hospital contact for depression identified in the Danish National Patient Registry (DNPR) from 1996 through 2014 were followed for TRD for 12 months after diagnosis. Socio-demographic and clinical risk factors were identified in nation-wide registries. Data were analyzed using Cox Proportional Hazard Regression and Fine-Gray model for competing mortality risk. Results: Indicators of disease severity (recurrent depression (adjusted HR (aHR) 1.17 (1.14–1.20)), severity of depression (aHR 2.01 (1.95–2.08)), admission to a psychiatric ward (aHR 2.03 (1.96, 2.10)) were strong risk factors. Aged 65–84 (aHR 1.96 (1.83–2.10)), lost labor market affiliation ((aHR 1.12 (1.08, 1.16)), cohabiting (aHR 1.27 (1.23, 1.30)), comorbid anxiety (aHR 1.18 (1.10–1.27)), insomnia (aHR 1.27 (1.06–1.51)), migraine (aHR 1.42 (1.16–1.73)) and use of psychotropic drugs was also associated with higher rates of TRD. Limitations: Information on drug use during hospitalization was not available. Information on rating scales could have provided a more precise assessment of symptom severity and treatment response. Conclusions: Besides indicators of disease severity, other important risk factors associated with TRD are age, lost labor market affiliation, cohabiting with a partner as well as anxiety, insomnia, migraine and the use of psychotropic medications.

KW - Treatment-resistant

KW - Depression

KW - Major depressive disorder

KW - Antidepressants

KW - Population-based study

KW - Epidemiology

U2 - 10.1016/j.jad.2019.10.005

DO - 10.1016/j.jad.2019.10.005

M3 - Journal article

C2 - 31655377

SN - 0165-0327

VL - 261

SP - 221

EP - 229

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

ER -

Socio-demographic and clinical risk factors of treatment-resistant depression: A Danish population-based cohort study

Abstract

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