title: Predicting 6-week treatment response to escitalopram pharmacotherapy in late-life major depressive disorder.
abstract: OBJECTIVE
  Approximately half of older patients treated for major depressive disorder (MDD) do not achieve symptomatic remission and functional recovery with first-line pharmacotherapy. This study aims to characterize sociodemographic, clinical, and neuropsychologic correlates of full, partial, and non-response to escitalopram monotherapy of unipolar MDD in later life.
  
  
  METHODS
  One hundred and seventy-five patients aged 60 and older were assessed at baseline on demographic variables, depression severity, hopelessness, anxiety, cognitive functioning, co-existing medical illness burden, social support, and quality of life (disability). Subjects received 10 mg/d of open-label escitalopram and were divided into full (n = 55; 31%), partial (n = 75; 42.9%), and non-responder (n = 45; 25.7%) groups based on Hamilton depression scores at week 6. Univariate followed by multivariate analyses tested for differences between the three groups.
  
  
  RESULTS
  Non-responders to treatment were found to be more severely depressed and anxious at baseline than both full and partial responders, more disabled, and with lower self-esteem than full responders. In general partial responders resembled full responders more than they resembled non-responders. In multivariate models, more severe anxiety symptoms (both psychological and somatic) and lower self-esteem predicted worse response status at 6 weeks.
  
  
  CONCLUSIONS
  Among treatment-seeking elderly persons with MDD, higher anxiety symptoms and lower self-esteem predict poorer response after six weeks of escitalopram treatment.
authors.affiliation: Western Psychiatric Institute and Clinic, Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, USA.
authors.forename: Ramin
authors.initials: R
authors.lastname: Saghafi
authors.forename: Charlotte
authors.initials: C
authors.lastname: Brown
authors.forename: Meryl A
authors.initials: MA
authors.lastname: Butters
authors.forename: Jill
authors.initials: J
authors.lastname: Cyranowski
authors.forename: Mary Amanda
authors.initials: MA
authors.lastname: Dew
authors.forename: Ellen
authors.initials: E
authors.lastname: Frank
authors.forename: Ariel
authors.initials: A
authors.lastname: Gildengers
authors.forename: Jordan F
authors.initials: JF
authors.lastname: Karp
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Lenze
authors.forename: Francis
authors.initials: F
authors.lastname: Lotrich
authors.forename: Lynn
authors.initials: L
authors.lastname: Martire
authors.forename: Sati
authors.initials: S
authors.lastname: Mazumdar
authors.forename: Mark D
authors.initials: MD
authors.lastname: Miller
authors.forename: Benoit H
authors.initials: BH
authors.lastname: Mulsant
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Weber
authors.forename: Ellen
authors.initials: E
authors.lastname: Whyte
authors.forename: Jennifer
authors.initials: J
authors.lastname: Morse
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Stack
authors.forename: Patricia R
authors.initials: PR
authors.lastname: Houck
authors.forename: Salem
authors.initials: S
authors.lastname: Bensasi
authors.forename: Charles F
authors.initials: CF
authors.lastname: Reynolds
mesh_terms: D000368:Aged; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D001007:Anxiety / Q000523:psychology; D015283:Citalopram / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012649:Self Concept; D012944:Social Support; D016896:Treatment Outcome
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram