Pre-treatment allostatic load and metabolic dysregulation predict SSRI response in major depressive disorder : A preliminary report
(2021) In Psychological Medicine 51(12). p.125-2117- Abstract
BackgroundMajor depressive disorder (MDD) is associated with increased allostatic load (AL; a measure of physiological costs of repeated/chronic stress-responding) and metabolic dysregulation (MetD; a measure of metabolic health and precursor to many medical illnesses). Though AL and MetD are associated with poor somatic health outcomes, little is known regarding their relationship with antidepressant-treatment outcomes.MethodsWe determined pre-treatment AL and MetD in 67 healthy controls and 34 unmedicated, medically healthy MDD subjects. Following this, MDD subjects completed 8-weeks of open-label selective serotonin reuptake inhibitor (SSRI) antidepressant treatment and were categorized as 'Responders' (≥50% improvement in depression... (More)
BackgroundMajor depressive disorder (MDD) is associated with increased allostatic load (AL; a measure of physiological costs of repeated/chronic stress-responding) and metabolic dysregulation (MetD; a measure of metabolic health and precursor to many medical illnesses). Though AL and MetD are associated with poor somatic health outcomes, little is known regarding their relationship with antidepressant-treatment outcomes.MethodsWe determined pre-treatment AL and MetD in 67 healthy controls and 34 unmedicated, medically healthy MDD subjects. Following this, MDD subjects completed 8-weeks of open-label selective serotonin reuptake inhibitor (SSRI) antidepressant treatment and were categorized as 'Responders' (≥50% improvement in depression severity ratings) or 'Non-responders' (<50% improvement). Logistic and linear regressions were performed to determine if pre-treatment AL or MetD scores predicted SSRI-response. Secondary analyses examined cross-sectional differences between MDD and control groups.ResultsPre-treatment AL and MetD scores significantly predicted continuous antidepressant response (i.e. absolute decreases in depression severity ratings) (p = 0.012 and 0.014, respectively), as well as post-treatment status as a Responder or Non-responder (p = 0.022 and 0.040, respectively), such that higher pre-treatment AL and MetD were associated with poorer SSRI-treatment outcomes. Pre-treatment AL and MetD of Responders were similar to Controls, while those of Non-responders were significantly higher than both Responders (p = 0.025 and 0.033, respectively) and Controls (p = 0.039 and 0.001, respectively).ConclusionsThese preliminary findings suggest that indices of metabolic and hypothalamic-pituitary-adrenal-axis dysregulation are associated with poorer SSRI-treatment response. To our knowledge, this is the first study to demonstrate that these markers of medical disease risk also predict poorer antidepressant outcomes.
(Less)
- author
- Hough, Christina M. ; Bersani, F. Saverio ; Mellon, Synthia H. ; Morford, Alexandra E. ; Lindqvist, Daniel LU ; Reus, Victor I. ; Epel, Elissa S. and Wolkowitz, Owen M. LU
- organization
- publishing date
- 2021-09-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Allostatic load, antidepressant response, major depressive disorder, metabolic dysregulation, metabolic syndrome, treatment prediction, treatment response
- in
- Psychological Medicine
- volume
- 51
- issue
- 12
- pages
- 9 pages
- publisher
- Cambridge University Press
- external identifiers
-
- pmid:32438932
- scopus:85085484156
- ISSN
- 0033-2917
- DOI
- 10.1017/S0033291720000896
- language
- English
- LU publication?
- yes
- id
- 09b16234-f43e-4a87-b3e3-2e38d5536465
- date added to LUP
- 2020-06-17 12:28:31
- date last changed
- 2025-01-23 15:02:48
@article{09b16234-f43e-4a87-b3e3-2e38d5536465, abstract = {{<p>BackgroundMajor depressive disorder (MDD) is associated with increased allostatic load (AL; a measure of physiological costs of repeated/chronic stress-responding) and metabolic dysregulation (MetD; a measure of metabolic health and precursor to many medical illnesses). Though AL and MetD are associated with poor somatic health outcomes, little is known regarding their relationship with antidepressant-treatment outcomes.MethodsWe determined pre-treatment AL and MetD in 67 healthy controls and 34 unmedicated, medically healthy MDD subjects. Following this, MDD subjects completed 8-weeks of open-label selective serotonin reuptake inhibitor (SSRI) antidepressant treatment and were categorized as 'Responders' (≥50% improvement in depression severity ratings) or 'Non-responders' (<50% improvement). Logistic and linear regressions were performed to determine if pre-treatment AL or MetD scores predicted SSRI-response. Secondary analyses examined cross-sectional differences between MDD and control groups.ResultsPre-treatment AL and MetD scores significantly predicted continuous antidepressant response (i.e. absolute decreases in depression severity ratings) (p = 0.012 and 0.014, respectively), as well as post-treatment status as a Responder or Non-responder (p = 0.022 and 0.040, respectively), such that higher pre-treatment AL and MetD were associated with poorer SSRI-treatment outcomes. Pre-treatment AL and MetD of Responders were similar to Controls, while those of Non-responders were significantly higher than both Responders (p = 0.025 and 0.033, respectively) and Controls (p = 0.039 and 0.001, respectively).ConclusionsThese preliminary findings suggest that indices of metabolic and hypothalamic-pituitary-adrenal-axis dysregulation are associated with poorer SSRI-treatment response. To our knowledge, this is the first study to demonstrate that these markers of medical disease risk also predict poorer antidepressant outcomes.</p>}}, author = {{Hough, Christina M. and Bersani, F. Saverio and Mellon, Synthia H. and Morford, Alexandra E. and Lindqvist, Daniel and Reus, Victor I. and Epel, Elissa S. and Wolkowitz, Owen M.}}, issn = {{0033-2917}}, keywords = {{Allostatic load; antidepressant response; major depressive disorder; metabolic dysregulation; metabolic syndrome; treatment prediction; treatment response}}, language = {{eng}}, month = {{09}}, number = {{12}}, pages = {{125--2117}}, publisher = {{Cambridge University Press}}, series = {{Psychological Medicine}}, title = {{Pre-treatment allostatic load and metabolic dysregulation predict SSRI response in major depressive disorder : A preliminary report}}, url = {{http://dx.doi.org/10.1017/S0033291720000896}}, doi = {{10.1017/S0033291720000896}}, volume = {{51}}, year = {{2021}}, }