Related Experiment Video
Updated: Jun 13, 2025
07:12
Individualized rTMS Treatment for Depression using an fMRI-Based Targeting Method
Published on: August 2, 2021
3.5K
Cause-specific mortality in treatment-resistant major depression: Population-based cohort study
Tapio T Gustafsson1, Heidi Taipale2, Markku Lähteenvuo1
1Department of Forensic Psychiatry, University of Eastern Finland, Niuvanniemi Hospital, Kuopio, Finland.
Journal of Affective Disorders
|September 13, 2024
Summary
Treatment-resistant major depression (TRD) is linked to a 17% higher risk of all-cause mortality. This increased mortality in TRD is primarily driven by suicides and accidental overdoses, not natural causes.
Area of Science:
- Psychiatry
- Epidemiology
- Public Health
Background:
- Limited evidence exists on the long-term prognosis for individuals with treatment-resistant major depression (TRD).
- Understanding mortality risks in TRD is crucial for informed clinical decision-making.
Purpose of the Study:
- To compare cause-specific mortality rates between individuals with TRD and those with non-TRD major depression.
- To investigate the long-term outcomes and mortality patterns in a large cohort of major depression patients.
Main Methods:
- Utilized Finnish national health registers to identify individuals diagnosed with major depression (MDD) between 2004-2016.
- Defined TRD based on the number of antidepressant treatment trials (over two).
- Employed Cox proportional hazard models to analyze cause-specific mortality, controlling for relevant covariates.
Main Results:
- A cohort of 176,942 individuals with MDD was followed for over 1.5 million person-years.
- Individuals meeting TRD criteria (11% of the cohort) exhibited a 17% higher all-cause mortality rate compared to non-TRD patients.
- Significantly increased mortality in TRD was observed for suicides (aHR 1.90) and accidental poisonings (aHR 1.81), with a higher proportion of drug overdoses.
Conclusions:
- The study highlights a substantially elevated mortality risk, particularly from suicide and accidental overdoses, in individuals with TRD.
- Findings suggest that TRD may be associated with more severe symptoms and suicidal ideation.
- Routine health data can be effectively used to define and study TRD prognosis.
Related Concept Videos
01:23Antidepressant Drugs: MAOIs and Other Agents
204
Atypical antidepressants, including bupropion (Wellbutrin), mirtazapine (Remeron), nefazodone (Serzone), trazodone (Desyrel), and vilazodone (Viibryd), offer unique mechanisms of action. Bupropion weakly inhibits dopamine and norepinephrine reuptake, aiding depression treatment and smoking cessation, with a low risk of sexual dysfunction. Mirtazapine enhances serotonin and norepinephrine neurotransmission, leading to sedation, increased appetite, and weight gain. As a result, it helps treat...
204
01:30Electroconvulsive Therapy
29
Electroconvulsive therapy (ECT), or shock therapy, remains a critical biomedical intervention for severe, treatment-resistant depression. While its origins can be traced back to Hippocrates' observations that malaria-induced convulsions alleviated mental illness, modern ECT has evolved significantly from its earlier, more primitive applications. First introduced in 1938 by Ugo Cerletti and his colleagues, ECT involves inducing controlled seizures using electrical currents. In its early...
29
02:56Treatment Resistant Cancers
3.3K
Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
3.3K
01:27Depressive Disorders: MDD and Dysthymia
69
Depressive disorders are a group of mental health conditions characterized by pervasive feelings of sadness, diminished pleasure in life, and a significant impact on daily functioning. These conditions are most prevalent in individuals during their 30s and affect women at twice the rate of men. Contrary to popular belief, younger individuals are generally more susceptible to these disorders than older adults. Two key types of depressive disorders include Major Depressive Disorder (MDD) and...
69
01:18Depression: Overview
227
Depression is a prevalent mental illness marked by persistent sadness and lack of interest in previously enjoyable activities. It can take several forms, including major depression, persistent depressive disorder, and bipolar I and II disorders. Symptoms range from emotional changes like chronic worry to physical changes like sleep disturbances and suicidal thoughts. From a neurobiological perspective, depression is believed to be triggered by abnormalities in the brain's prefrontal cortex,...
227
02:50Combination Therapies and Personalized Medicine
4.9K
Combining two or more treatment methods increases the life span of cancer patients while reducing damage to vital organs or tissue from the overuse of a single treatment. Combination therapy also targets different cancer-inducing pathways, thus reducing the chances of developing resistance to treatment.
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
The combination of the drug acetazolamide and sulforaphane is a good example of combination therapy to treat cancer. The cells in the interior of a large tumor often die due to the hypoxic and...
4.9K