Predicting Response to Depression Treatments

According to the World Health Organization, depression is currently the leading cause of disability worldwide. Several barriers to treatment have been identified (eg, failure to seek treatment, limited accessibility). Another problem is the variable efficacy of different treatments (eg, medications, psychotherapy) among specific individuals, which can lead to a prolonged recovery rate or failure to recover at all. Despite concerted efforts, there remains no scientifically supported method for determining individualized treatment plans for depression.

In a recent study, we and our colleagues aimed to identify clinically useful predictors of treatment response in a real-world scenario. Specifically, 75 depressed adults seeking treatment at an outpatient mental health facility were recruited to complete a brief (<30 min) computerized cognitive assessment as part of their clinical intake process. The computerized tests measured attention and impulse control, recognition of emotional expressions, and intelligence. Participants also completed a depression severity questionnaire prior to their intake appointment and again at regular intervals to monitor for improvement in depressive symptoms.

Participants received standard treatments for their depression that included antidepressant medication and/or psychotherapy. Treatment outcome was analyzed 4 to 6 months following initial presentation to the clinic.

At follow-up, most participants’ depression severity scores had improved from moderately severe depression to mild depression. Response inhibition (ie, a cognitive measure reflecting impulse control), baseline depression scores, and education explained nearly 30% of the variance in the change in depression scores over time.

These results suggest that cognitive screening at initial presentation to an outpatient mental health clinic for symptoms of depression might help identify individuals who may be less responsive to usual treatments. Additional research is needed to identify how to better serve that portion of depressed adults.

Financial disclosure:Drs Dawson and Langenecker have no relevant personal financial relationships to report.