TY - JOUR
T1 - Impact of physical and sexual abuse on treatment response in the treatment of resistant depression in adolescent study (TORDIA)
AU - Shamseddeen, Wael
AU - Asarnow, Joan Rosenbaum
AU - Clarke, Gregory
AU - Vitiello, Benedetto
AU - Wagner, Karen Dineen
AU - Birmaher, Boris
AU - Keller, Martin B.
AU - Emslie, Graham
AU - Iyengar, Satish
AU - Ryan, Neal D.
AU - McCracken, James T.
AU - Porta, Giovanna
AU - Mayes, Taryn
AU - Brent, David A.
N1 - Funding Information:
This work was supported by National Institute of Mental Health (NIMH) grants MH61835 (Pittsburgh); MH61856 (Galveston); MH61864 (UCLA); MH61869 (Portland); MH61958 (Dallas); and MH62014 (Brown), and MH66371 (Pittsburgh). NIMH program staff participated in the design, implementation, analysis, and preparation of reports of the study.
Funding Information:
Disclosure: Dr. Asarnow has served as a consultant for Pfizer. She has received funding from Philip Morris . A family member receives funding from Bristol-Myers Squibb , and has served as a consultant for Roche, Novartis, Sanofi-Adventis, and Janssen. Dr. Wagner has received research support from the National Institute of Mental Health , and has served on the advisory board for Forest. Dr. Birmaher receives research support from the National Institute of Mental Health . He has served as a consultant for Schering Plough. He has participated in advisory board forums sponsored by Dey Pharma, L.P., and Forest. He has received royalties from Random House and Lippincott Williams and Wilkins. Dr. Keller has served as a consultant or received honoraria from Abbott, CENEREX, Cephalon, Cypress Bioscience, Cyberonics, Forest, Janssen, JDS, Medtronic, Organon, Novartis, Pfizer, Roche, Solvey, Wyeth, and Sierra Neuropharmaceuticals. He has received research support from Pfizer . He has served on the advisory boards for Abbott, Bristol-Myers Squibb, CENEREX, Cyberonics, Cypress Bioscience, Forest, Janssen, Neuronetics, Novartis, Organon, and Pfizer. Dr. McCracken has received research support from Seaside Pharmaceuticals , Bristol-Myers Squibb , and Aspect . He has served as a consultant to BioMarin and Shionogi. He has received honoraria from the American Academy of Child and Adolescent Psychiatry, the Tourette Syndrome Association, CME Outfitters, and Veritas. Dr. Emslie has received research support from Biobehavioral Diagnostics , Eli Lilly and Co. , Forest , GlaxoSmithKline , and Somerset . He has served as a consultant for Biobehavioral Diagnostics, Eli Lilly and Co., Forest, GlaxoSmithKline, Pfizer, and Wyeth. Dr. Brent has received research support from the National Institute of Mental Health . He has received royalties from Guilford Press. He serves as an editor for UpToDate Psychiatry. Drs. Shamseddeen, Clarke, Vitiello, Iyengar, and Ryan, and Ms. Mayes and Ms. Porta report no biomedical financial interests or potential conflicts of interest.
PY - 2011/3
Y1 - 2011/3
N2 - Objective: We previously reported that a history of abuse was associated with a poorer response to combination treatment in the Treatment of Resistant Depression in Adolescents study (TORDIA). We now report on the nature and correlates of abuse that might explain these findings. Method: Youth who did not benefit from an adequate selective serotonin re-uptake inhibitor (SSRI) trial (N = 334) were randomized to one of the following: an alternative SSRI; an alternative SSRI plus cognitive behavior therapy (CBT); venlafaxine; or venlafaxine plus CBT. Analyses examined the effect of history of abuse on response to the pharmacotherapy and combination therapy. Results: Those without a history of physical abuse (PA) or sexual abuse (SA) had a higher 12-week response rate to combination therapy compared with medication mono-therapy (62.8% versus 37.6%; odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.6-4.7, p < .001). Those with a history of SA had similar response rates to combination versus medication monotherapy (48.3% versus 42.3%; OR = 1.3, 95% CI = 0.43.7; p = .66), whereas those with history of PA had a much lower rate of response to combination therapy (18.4% versus 52.4%, OR = 0.1; 95% CI = 0.020.43). Even after adjusting for other clinical predictors, a history of PA moderated treatment outcome. Conclusion: These results should be considered within the limitations of a post hoc analysis, lack of detailed assessment of abuse and other forms of trauma, and neuropsychological status. Depressed patients with history of abuse, especially PA may require specialized clinical approaches. Further work is needed to understand by what mechanisms a history of abuse affects treatment response. Clinical Trial Registry Information: Treatment of SSRI-Resistant Depression in Adolescents (TORDIA); NCT00018902; http://www.clinicaltrials.gov.
AB - Objective: We previously reported that a history of abuse was associated with a poorer response to combination treatment in the Treatment of Resistant Depression in Adolescents study (TORDIA). We now report on the nature and correlates of abuse that might explain these findings. Method: Youth who did not benefit from an adequate selective serotonin re-uptake inhibitor (SSRI) trial (N = 334) were randomized to one of the following: an alternative SSRI; an alternative SSRI plus cognitive behavior therapy (CBT); venlafaxine; or venlafaxine plus CBT. Analyses examined the effect of history of abuse on response to the pharmacotherapy and combination therapy. Results: Those without a history of physical abuse (PA) or sexual abuse (SA) had a higher 12-week response rate to combination therapy compared with medication mono-therapy (62.8% versus 37.6%; odds ratio [OR] = 2.8, 95% confidence interval [CI] = 1.6-4.7, p < .001). Those with a history of SA had similar response rates to combination versus medication monotherapy (48.3% versus 42.3%; OR = 1.3, 95% CI = 0.43.7; p = .66), whereas those with history of PA had a much lower rate of response to combination therapy (18.4% versus 52.4%, OR = 0.1; 95% CI = 0.020.43). Even after adjusting for other clinical predictors, a history of PA moderated treatment outcome. Conclusion: These results should be considered within the limitations of a post hoc analysis, lack of detailed assessment of abuse and other forms of trauma, and neuropsychological status. Depressed patients with history of abuse, especially PA may require specialized clinical approaches. Further work is needed to understand by what mechanisms a history of abuse affects treatment response. Clinical Trial Registry Information: Treatment of SSRI-Resistant Depression in Adolescents (TORDIA); NCT00018902; http://www.clinicaltrials.gov.
KW - Depression
KW - abuse
KW - cognitive behavioral therapy
KW - selective serotonin reuptake inhibitor
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UR - http://www.scopus.com/inward/citedby.url?scp=79951856958&partnerID=8YFLogxK
U2 - 10.1016/j.jaac.2010.11.019
DO - 10.1016/j.jaac.2010.11.019
M3 - Article
C2 - 21334569
AN - SCOPUS:79951856958
SN - 0890-8567
VL - 50
SP - 293
EP - 301
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 3
ER -