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Journal ArticleDOI

Acute and Longer- Term Outcomes in Depressed Outpatients Requiring One or Several Treatment Steps: A STAR*D Report

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TLDR
The acute and longer-term treatment outcomes associated with each of four successive steps in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial are described and compared.
Abstract
Objective: This report describes the participants and compares the acute and longer-term treatment outcomes associated with each of four successive steps in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. Method: A broadly representative adult outpatient sample with nonpsychotic major depressive disorder received one (N=3,671) to four (N=123) successive acute treatment steps. Those not achieving remission with or unable to tolerate a treatment step were encouraged to move to the next step. Those with an acceptable benefit, preferably symptom remission, from any particular step could enter a 12-month naturalistic follow-up phase. A score of ≤5 on the Quick Inventory of Depressive Symptomatology–Self-Report (QIDS-SR 16 ) (equivalent to ≤7 on the 17-item Hamilton Rating Scale for Depression [HRSD 17 ]) defined remission; a QIDS-SR 16 total score of ≥11 (HRSD 17 ≥14) defined relapse. Results: The QIDS-SR 16 remission rates were 36.8%, 30.6%, 13.7%, and 13.0% for the first, second, t...

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Citations
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Escitalopram in the treatment of major depressive disorder: A meta-analysis

TL;DR: In this meta-analysis, superior efficacy of escitalopram compared to SSRIs and SNRIs was confirmed, although the superiority over SSR Is was largely explained by differences between escitalobram and citaloprams.
Journal ArticleDOI

Role of neuro-immunological factors in the pathophysiology of mood disorders.

TL;DR: Evidence that the release of neuroactive cytokines, particularly interleukins such as IL-1β, IL-6, and TNF-α, is altered in these disorders is reviewed and mechanisms such as the ATP-gated ion channel P2X7, through which cytokine signaling can influence neuro-glial interactions are discussed.
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Time for united action on depression: a Lancet–World Psychiatric Association Commission

TL;DR: Styron as discussed by the authors describes depression as "a disorder of mood, so mysteriously painful and elusive in the way it becomes known to the self, to the mediating intellect, as to verge close to being beyond description".
Journal ArticleDOI

Convergent Mechanisms Underlying Rapid Antidepressant Action.

TL;DR: Proposed mechanisms of the antidepressant action of ketamine include N-methyl-d-aspartate receptor (NMDAR) modulation, gamma aminobutyric acid (GABA)-ergic interneuron disinhibition, and direct actions of its hydroxynorketamine (HNK) metabolites.
Journal ArticleDOI

Why antidepressants are not antidepressants: STEP‐BD, STAR*D, and the return of neurotic depression

TL;DR: The widely held clinical view of 'antidepressants' as highly effective and specific for the treatment of all types of depressive disorders is exaggerated and is supported by recent findings from the NIMH-sponsored STEP-BD and STAR*D projects.
References
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Journal ArticleDOI

Cumulative illness rating scale.

TL;DR: A Cumulative Illness Rating Scale, designed to meet the need for a brief, comprehensive and reliable instrument for assessing physical impairment, has been developed and tested and is well suited to a variety of research uses.
Journal ArticleDOI

The Inventory of Depressive Symptomatology (IDS): Psychometric properties.

TL;DR: Analysis of sensitivity to change in symptom severity in an open-label trial of fluoxetine showed that the IDs-C and IDS-SR were highly related to the 17-item Hamilton Rating Scale for Depression.
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