Family history of depression and therapeutic outcome: findings from STAR*D.
OBJECTIVE
It is unclear whether a positive family history of depression affects the clinical presentation or effectiveness of treatment for major depressive disorder (MDD). We aimed to determine whether depressed patients with a positive family history of depression differed from those without in terms of baseline sociodemographic and clinical characteristics, including concurrent comorbid conditions and treatment outcome with citalopram in a large, multicenter effectiveness trial.


METHODS
Clinical outcome and sociodemographic information were collected on 2876 participants with DSM-IV MDD enrolled from July 2001 through April 2004 in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. Participants with and without a family history of depression, as determined by self-report at initial assessment, were compared.


RESULTS
Over half (55.6%) (1585/2853) of the evaluable sample reported a positive family history of depression. A positive family history of depression was associated with an earlier age at onset of MDD, a longer length of illness, and more comorbid generalized anxiety disorder and prior suicide attempts. These participants had a slightly faster onset of remission, and slightly greater side effect burden, but they did not differ overall in response or remission rates.


CONCLUSIONS
A family history of depression was associated with several clinical characteristics, although its usefulness as a predictor of treatment outcome is questionable. The slightly faster remission with an SSRI despite the slightly greater side effect burden indicates the effectiveness of using an SSRI in treating depressed patients both with and without a family history of depression.


BACKGROUND
clinicaltrials.gov Identifier: NCT00021528.
Husain
Mustafa M
MM
Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX 75390-8898, USA. mustafa.husain@utsouthwestern.edu
Rush
A John
AJ
Wisniewski
Stephen R
SR
McClintock
Shawn M
SM
Fava
Maurizio
M
Nierenberg
Andrew A
AA
Davis
Lori
L
Balasubramani
G K
GK
Young
Elizabeth
E
Albala
A Ari
AA
Trivedi
Madhukar H
MH
D000328:Adult; D000367:Age Factors; D000437:Alcoholism / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D015283:Citalopram / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology / Q000235:genetics* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D013405:Suicide / Q000523:psychology / Q000706:statistics & numerical data; D013406:Suicide, Attempted / Q000523:psychology / Q000706:statistics & numerical data; D016896:Treatment Outcome
D000928:Antidepressive Agents; D015283:Citalopram