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Staging methods for treatment resistant depression. A systematic review.

Henricus G Ruhé¹, Geeske van Rooijen, Jan Spijker

¹Program for Mood Disorders, Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. H.G.Ruhe@amc.uva.nl

Journal of Affective Disorders

|March 26, 2011

Summary

Identifying staging models for treatment-resistant depression (TRD) is crucial. The Maudsley Staging Model (MSM) shows the best predictive utility, though further reliability studies are needed for TRD staging.

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Area of Science:

Psychiatry
Clinical Psychology
Pharmacology

Background:

Treatment-resistant depression (TRD) lacks routine staging.
Existing staging models for TRD are not consistently applied in clinical practice.

Purpose of the Study:

To identify and compare TRD staging models.
To evaluate their predictive utility and reliability.

Main Methods:

Systematic review of PubMed, Embase, and PsycINFO (1985-2010).
Qualitative summary of staging model characteristics, strengths, and limitations.
Reported validation study results.

Main Results:

Five staging models identified: Antidepressant Treatment History Form, Thase and Rush Model, European Staging Model, Massachusetts General Hospital Staging model, and Maudsley Staging Model (MSM).
Maudsley Staging Model (MSM) demonstrated the best predictive utility.
Evolution towards multidimensional, continuously scored models with improved operationalization criteria and validation efforts.

Conclusions:

Few TRD staging models exist, with limited reliability assessment.
Further research on reliability and predictive utility of TRD staging models is necessary.
Improved TRD staging can enhance clinical study generalizability and patient care.