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Title of Journal: Eur Arch Psychiatry Clin Neurosci

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Abbravation: European Archives of Psychiatry and Clinical Neuroscience

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Springer-Verlag

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1433-8491

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Type of residual symptom and risk of relapse durin

Authors: Huaiyu Yang Sarah Chuzi Lara SinicropiYao Dan Johnson Ying Chen Alisabet Clain Lee Baer Patrick J McGrath Jonathan W Stewart Maurizio Fava George I Papakostas
Publish Date: 2009/07/02
Volume: 260, Issue: 2, Pages: 145-150
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Abstract

Relapse of major depressive disorder MDD is a common clinical problem Identifying relapse predictors could lead to strategies that reduce relapse risk This study is designed to determine whether residual symptoms predict relapse risk during the continuation/maintenance treatment of MDD 570 MDD patients received openlabel fluoxetine for 12 weeks Under double blind conditions 262 patients who responded by week 12 were randomly assigned to continue fluoxetine or switch to placebo for 52 weeks or until relapse Residual symptoms were measured using the Symptom Checklist90 and the Symptom Questionnaire The relationship between residual symptom severity and relapse risk was assessed Without adjusting for overall residual symptom severity a greater severity of residual obsessivecompulsive and phobic anxiety symptoms predicted greater relapse risk After adjusting for overall residual symptom severity only severity of phobic anxiety symptoms predicted relapse risk The predictive value of phobic anxiety symptoms with respect to relapse risk was independent of treatment assignment The results indicated that there may be a specific pattern of residual symptoms associated with depressive relapse during antidepressant continuation/maintenance which is unrelated to treatment assignment Future studies are needed to further explore the relationship between residual symptoms and relapse risk in MDD Clinical implications 1 It is important to treat residual symptoms among antidepressant responders/remitters in order to decrease relapse risk 2 Clinicians should target residual phobic anxiety symptoms in order to decrease relapse risk 3 Clinicians should target residual obsessivecompulsive symptoms in order to decrease relapse risk Limitations 1 limited generalizability due to inclusion/exclusion criteria 2 lack of active comparator treatment group 3 post hoc analysis

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