TY - JOUR PY - 2020// TI - Staging of depressive disorders: relevance of resistance to treatment and residual symptoms JO - Journal of psychiatric research A1 - Reneses, Blanca A1 - Aguera-Ortiz, Luis A1 - Sevilla-Llewellyn-Jones, Julia A1 - Carrillo, Antonio A1 - Argudo, Isabel A1 - Regatero, María Jose A1 - López-Micó, Cristina A1 - Fuentes, Manuel A1 - Palomo, Tomas SP - 234 EP - 240 VL - 129 IS - N2 - BACKGROUND: Clinical staging model for depression helps to better define the clinical situation of patients. The objectives of this study are: to correlate the Hetrick's staging model of depression with the severity of depression, associated disability, and resistance to treatment in the established disease stages and to test the modification introduced by our group consisting in the introduction of a substage for recurrence from a previous episode that was stabilized with a complete remission. METHODS: A Cross-sectional study with 133 adult subjects having a current and primary diagnosis of Depressive disorder was developed. Patients were classified according to the model and assessed with: 17-item Hamilton Depression Scale (HAM-D), Clinical Global Impression (CGI); Global Assessment of Function (GAF); Maudsley Staging Method for treatment resistance (MSM) and Sheeham Disability Schedule (SDS). RESULTS: The variable that best contributes to the differentiation between clinical stages, in established Depression, is resistance to treatment evaluated by the MSM. Correlations between MSM and the clinical stages were statistically significant between most pairs of stages. Finally, we showed preliminary data in order to prove that a differential sub-stage for recurrent depression with and without inter-episodic remission in the current heuristic models could be a possible stage for better define depression staging model. CONCLUSIONS: Resistance to treatment should be included in the definition of clinical stages in established depression. Despite the difficulty of establishing a valid model for the staging of depression, it can certainly add great value to diagnosis, therapeutic interventions and clinical research.

Language: en

LA - en SN - 0022-3956 UR - http://dx.doi.org/10.1016/j.jpsychires.2020.07.022 ID - ref1 ER -