Table 1.
MDD patients' (Bartova et al., 2019) sociodemographic, clinical, and treatment characteristics itemized according to their sex
| MDD patients' characteristics | MDD sample in total (n = 1410) | Male MDD patients (n = 467) | Female MDD patients (n = 943) | χ2/F | p Value (χ2/ANOVA) | AOR (95% CI)/F | p Value (regression analyses/ANCOVA) |
|---|---|---|---|---|---|---|---|
| Age, mean (SD), years | 50.3 (14.1) | 50.4 (13.8) | 50.2 (14.3) | 0.0 | .890 | ||
| Ethnic origin, n (%) | |||||||
| Caucasian | 1356 (96.2) | 451 (96.6) | 905 (96) | 0.3 | .578 | ||
| Educational status, n (%) (n = 1395) | |||||||
| University education/nonuniversity high education/high‐level general education | 755 (53.5) | 267 (57.5) | 488 (52.4) | 3.3 | .070 | ||
| General secondary/technical education/elementary school/none | 640 (45.4) | 197 (42.5) | 443 (47.6) | ||||
| Occupational status, n (%) (n = 1408) | |||||||
| Employed | 659 (46.7) | 231 (49.5) | 428 (45.5) | 2.0 | .159 | ||
| Unemployed | 749 (53.1) | 236 (50.5) | 513 (54.5) | ||||
| Relationship status, n (%) | |||||||
| With ongoing relationship | 703 (49.9) | 252 (54) | 451 (47.8) | 4.7 | .03 | 0.785 (0.627–0.984) | .036 |
| Without ongoing relationship | 707 (50.1) | 215 (46) | 492 (52.2) | ||||
| Major depressive episode, n (%) | |||||||
| Single | 127 (9.0) | 39 (8.4) | 88 (9.3) | 0.4 | .545 | ||
| Recurrent | 1283 (91.0) | 428 (91.6) | 855 (90.7) | ||||
| Specific features, n (%) | |||||||
| Psychotic features | 154 (10.9) | 57 (12.2) | 97 (10.3) | 1.2 | .277 | ||
| Melancholic features | 856 (60.7) | 291 (62.3) | 565 (59.9) | 0.8 | .386 | ||
| Atypical features | 33 (2.3) | 9 (1.9) | 24 (2.5) | 0.5 | .470 | ||
| Catatonic features | 7 (0.5) | 2 (0.4) | 5 (0.5) | 0.1 | .798 | ||
| Suicidalitya | |||||||
| Current suicidal risk (dichotomous) | 649 (46.0) | 228 (48.8) | 421 (44.6) | 2.2 | .139 | ||
| Degree of suicidal risk in patients with current suicidal risk, n (%) (n = 649) | |||||||
| High/moderate | 377 (58.1) | 145 (63.6) | 232 (55.1) | 4.4 | .036 | 0.694 (0.497–0.970) | .033 |
| Low | 272 (41.9) | 83 (36.4) | 189 (44.9) | ||||
| Treatment setting, n (%) | |||||||
| Inpatient | 488 (34.6) | 190 (40.7) | 298 (31.6) | 11.4 | <.001 | 0.713 (0.555–0.917) | .008 |
| Outpatient | 922 (65.4) | 277 (59.3) | 645 (68.4) | ||||
| Duration of the current MDE, mean (SD), days | 204.7 (164.6) | 200.4 (165.5) | 206.9 (164.3) | 0.4 | .536 | ||
| Number of MDEs during lifetime, mean (SD) | 3.3 (2.5) | 3.2 (2.5) | 3.4 (2.4) | 0.7 | .412 | ||
| Age of MDD onset, mean (SD), years | 37.2 (15.4) | 38.9 (15.4) | 36.4 (15.4) | 7.6 | .006 | 13.2 | <.001 |
| Duration of psychiatric hospitalizations during lifetime, mean (SD), weeks (n = 1328) | 5.6 (20.5) | 6.0 (23.9) | 5.4 (18.5) | 0.2 | .641 | ||
| Psychiatric comorbidities, n (%) | |||||||
| Any anxiety disorder | 294 (20.9) | 101 (21.6) | 193 (20.5) | 0.3 | .614 | ||
| Generalized anxiety disorder | 151 (10.7) | 51 (10.9) | 100 (10.6) | 0.0 | .857 | ||
| Panic disorder | 114 (8.1) | 35 (7.5) | 79 (8.4) | 0.3 | .567 | ||
| Agoraphobia | 113 (8.0) | 36 (7.7) | 77 (8.2) | 0.1 | .766 | ||
| Social phobia | 45 (3.2) | 17 (3.6) | 28 (3.0) | 0.5 | .500 | ||
| Obsessive–compulsive disorder | 22 (1.6) | 6 (1.3) | 16 (1.7) | 0.3 | .565 | ||
| Posttraumatic stress disorder | 20 (1.4) | 5 (1.1) | 15 (1.6) | 0.6 | .437 | ||
| Somatic comorbidities, n (%) | |||||||
| Any somatic comorbidity | 653 (46.3) | 197 (42.2) | 456 (48.4) | 4.8 | .029 | 1.336 (1.056–1.690) | .016 |
| Hypertension | 267 (18.9) | 102 (21.8) | 165 (17.5) | 3.8 | .05 | ||
| Thyroid dysfunction | 204 (14.5) | 31 (6.6) | 173 (18.3) | 34.6 | <.001 | 3.466 (2.305–5.210) | <.001 |
| Migraine | 156 (11.1) | 29 (6.2) | 127 (13.5) | 16.7 | <.001 | 2.425 (1.590–3.699) | <.001 |
| Diabetes | 84 (6.0) | 34 (7.3) | 50 (5.3) | 2.2 | .140 | ||
| Heart disease | 72 (5.1) | 31 (6.6) | 41 (4.3) | 3.4 | .066 | ||
| Arthritis | 65 (4.6) | 19 (4.1) | 46 (4.9) | 0.5 | .495 | ||
| Asthma | 48 (3.4) | 7 (1.5) | 41 (4.3) | 7.7 | .005 | 2.990 (1.328–6.730) | .008 |
| Pain | 8 (0.6) | 2 (0.4) | 6 (0.6) | 0.2 | .625 | ||
| Severity of depressive symptoms, mean (SD) | |||||||
| HAM‐D total 21‐item at study entry | 19.8 (9.1) | 19.9 (8.8) | 19.7 (9.2) | 0.2 | .680 | ||
| MADRS total at study entry (cMADRS) | 24.6 (11.3) | 24.5 (11.1) | 24.7 (11.4) | 0.1 | .763 | ||
| MADRS total at onset of the current MDE (rMADRS) | 34.1 (7.7) | 34.5 (7.6) | 33.8 (7.7) | 2.5 | .117 | ||
| Treatment response, n (%)b | |||||||
| Response | 346 (24.5) | 121 (25.9) | 225 (23.9) | 2.4 | .300 | ||
| Nonresponse | 492 (34.9) | 150 (32.1) | 342 (36.3) | ||||
| Resistance | 572 (40.6) | 196 (42.0) | 376 (39.9) | ||||
| MADRS total change (rMADRS–cMADRS), mean (SD) | −9.4 (10.8) | −10.0 (10.7) | −9.0 (10.8) | 2.4 | .124 | ||
| Ongoing psychotherapy, n (%) (n = 1279) | |||||||
| Any psychotherapy | 399 (28.3) | 128 (30) | 271 (31.8) | 0.4 | .505 | ||
| Cognitive‐behavioral therapy | 292 (20.7) | 96 (22.5) | 196 (23) | 4.0 | .409 | ||
| Psychoanalytic psychotherapy | 43 (3.0) | 16 (3.7) | 27 (3.2) | ||||
| Systemic psychotherapy | 16 (1.1) | 6 (1.4) | 10 (1.2) | ||||
| Other psychotherapy | 48 (3.4) | 10 (2.3) | 38 (4.5) | ||||
| Ongoing psychopharmacotherapy | |||||||
| Number of concurrently administered psychopharmacotherapeutics, mean (SD) | 2.18 (1.2) | 2.3 (1.2) | 2.1 (1.2) | 3.2 | .073 | ||
| Administered first‐line antidepressant (in the current MDE), n (%) | |||||||
| Selective serotonin reuptake inhibitors | 734 (52.1) | 233 (49.9) | 501 (53.1) | 1.3 | .252 | ||
| Serotonin‐norepinephrine reuptake inhibitors | 336 (23.8) | 97 (20.8) | 239 (25.3) | 3.6 | .058 | ||
| Noradrenergic and specific serotonergic antidepressants | 121 (8.6) | 57 (12.2) | 64 (6.8) | 11.7 | <.001 | 0.550 (0.375–0.807) | .002 |
| Tricyclic antidepressants | 74 (5.2) | 29 (6.2) | 45 (4.8) | 1.3 | .254 | ||
| Agomelatine | 69 (4.9) | 18 (3.9) | 51 (5.4) | 1.6 | .203 | ||
| Noradrenaline‐dopamine reuptake inhibitors | 32 (2.3) | 15 (3.2) | 17 (1.8) | 2.8 | .094 | ||
| Serotonin antagonist and reuptake inhibitors | 28 (2.0) | 10 (2.1) | 18 (1.9) | 0.1 | .768 | ||
| Vortioxetine | 6 (0.4) | 3 (0.6) | 3 (0.3) | 0.8 | .379 | ||
| Monoamine oxidase inhibitors | 5 (0.4) | 2 (0.4) | 3 (0.3) | 0.1 | .743 | ||
| Noradrenaline reuptake inhibitors | 3 (0.2) | 2 (0.4) | 1 (0.1) | 1.5 | .217 | ||
| Tianeptine | 2 (0.1) | 1 (0.2) | 1 (0.1) | 0.3 | .612 | ||
| Fluoxetine equivalentsc, mean (SD), mg/day | 39.86 (20.8) | 42.6 (23.7) | 38.5 (19.0) | 11.2 | <.001 | 10.0 | .002 |
| Employed psychopharmacotherapeutic combination and augmentation strategies (in addition to the ongoing antidepressant treatment), n (%) | |||||||
| Any combination and augmentation treatment | 855 (60.6) | 304 (65.1) | 551 (58.4) | 5.8 | .016 | 0.771 (0.607–0.979) | .033 |
| Combination with at least 1 additional antidepressant | 416 (29.5) | 157 (33.6) | 259 (27.5) | 5.7 | .017 | ||
| Augmentation with at least 1 antipsychotic drug | 362 (25.7) | 132 (28.3) | 230 (24.4) | 2.5 | .117 | ||
| Augmentation with at least 1 mood stabilizer | 159 (11.3) | 64 (13.7) | 95 (10.1) | 4.1 | .043 | 0.685 (0.486–0.966) | .031 |
| Augmentation with pregabalin | 102 (7.2) | 33 (7.1) | 69 (7.3) | 0.0 | .864 | ||
| Augmentation with at least 1 low‐potency antipsychoticd | 91 (6.5) | 25 (5.4) | 66 (7.0) | 1.4 | .237 | ||
| Augmentation with benzodiazepines including zolpidem and zopiclone | 466 (33.0) | 148 (31.7) | 318 (33.7) | 0.6 | .446 | ||
Note: The p values indicated in bold were significant after Bonferroni–Holm correction.
Abbreviations: ANCOVA, analysis of covariance; ANOVA, analysis of variance; AOR, adjusted odds ratio; CI, confidence interval; HAM‐D, Hamilton Depression Rating Scale; MADRS, Montgomery Åsberg Depression Rating Scale (cMADRS, current MADRS; rMADRS, retrospective MADRS); MDD, major depressive disorder; MDE, major depressive episode; n, number of participants; SD, standard deviation.
a
The presence of the current suicidal risk was measured based on the HAM‐D item 3 (suicidality) ratings (Dold, Bartova, Fugger et al., 2018). While the absence of the current suicidal risk was based on an item score of 0 (absent), the presence of the current suicidal risk was represented by item scores of 1 (feels life is not worth living), 2 (wishes to be dead, or any thoughts of possible death to self), 3 (suicide ideas or gestures), or 4 (suicide attempts).
b
Nonresponse was defined by a previous single failed trial and treatment resistance by two or more failed trials (Bartova et al., 2019).
c
Fluoxetine dose equivalents were calculated according to Hayasaka et al. (2015).
d
Low‐potency antipsychotics comprise the so‐called low‐potency first‐generation antipsychotics and the second‐generation antipsychotic quetiapine less than 100 mg/day (Bartova et al., 2019).