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Title: Clinical factors predicting treatment resistant depression : affirmative results from the European multicenter study
Authors: Kautzky, A
Dold, M
Bartova, L
Spies, M
Kranz, GS 
Souery, D
Montgomery, S
Mendlewicz, J
Zohar, J
Fabbri, C
Serretti, A
Lanzenberger, R
Dikeos, D
Rujescu, D
Kasper, S
Keywords: Antidepressives
Clinical aspects
Issue Date: 2018
Publisher: Wiley-Blackwell
Source: Acta psychiatrica Scandinavica, 2018, v. 139, no. 1, p. 78-88 How to cite?
Journal: Acta psychiatrica Scandinavica 
Abstract: Objectives: Clinical variables were investigated in the ‘treatment resistant depression (TRD)- III’ sample to replicate earlier findings by the European research consortium ‘Group for the Study of Resistant Depression’ (GSRD) and enable cross-sample prediction of treatment outcome in TRD.
Experimental procedures: TRD was defined by a Montgomery and Åsberg Depression Rating Scale (MADRS) score ≥22 after at least two antidepressive trials. Response was defined by a decline in MADRS score by ≥50% and below a threshold of 22. Logistic regression was applied to replicate predictors for TRD among 16 clinical variables in 916 patients. Elastic net regression was applied for prediction of treatment outcome.
Results: Symptom severity (odds ratio (OR) = 3.31), psychotic symptoms (OR = 2.52), suicidal risk (OR = 1.74), generalized anxiety disorder (OR = 1.68), inpatient status (OR = 1.65), higher number of antidepressants administered previously (OR = 1.23), and lifetime depressive episodes (OR = 1.15) as well as longer duration of the current episode (OR = 1.022) increased the risk of TRD. Prediction of TRD reached an accuracy of 0.86 in the independent validation set, TRD-I.
Conclusion: Symptom severity, suicidal risk, higher number of lifetime depressive episodes, and comorbid anxiety disorder were replicated as the most prominent risk factors for TRD. Significant predictors in TRD-III enabled robust prediction of treatment outcome in TRD-I.
ISSN: 0001-690X
EISSN: 1600-0447
DOI: 10.1111/acps.12959
Rights: © 2018 The Authors Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
The following publication Kautzky, A., Dold, M., Bartova, L., Spies, M., Kranz, G. S., Souery, D., ... & Serretti, A. (2019). Clinical factors predicting treatment resistant depression: affirmative results from the European multicenter study. Acta Psychiatrica Scandinavica, 139(1), 78-88 is available at
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