title: Medical comorbidity affects antidepressant treatment response in patients with melancholic depression.
abstract: BACKGROUND
  This study aimed at the impact of medical comorbidity (MC) on response to antidepressant treatment over 6 weeks in diagnostic subtypes of patients with major depressive episode (MDE).
  
  
  METHODS
  In a clinical sample of 241 admitted patients with MDE, MC was assessed by medical specialists and weekly response to antidepressant treatment was assessed with the Hamilton Depression Scale (HAM-D 21).
  
  
  RESULTS
  Over 6 weeks of treatment, patients with melancholic depression and MC had poorer treatment response on the HAM-D scale and a worse functional outcome (GAF) as opposed to their counterparts without MC, which was first detected after 4 weeks of treatment (p = 0.02). More specifically, subjects with melancholic depression and cardiovascular or endocrinological MC showed significantly poorer treatment response over 6 weeks. Interestingly, these effects were not related to various antidepressant treatment regimens.
  
  
  CONCLUSIONS
  MC has a negative impact on treatment response in patients with melancholic depression.
authors.affiliation: Department of Psychiatry, University of Muenster, Muenster, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Pohle
authors.forename: K
authors.initials: K
authors.lastname: Domschke
authors.forename: T
authors.initials: T
authors.lastname: Roehrs
authors.forename: V
authors.initials: V
authors.lastname: Arolt
authors.forename: B T
authors.initials: BT
authors.lastname: Baune
mesh_terms: D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000627:therapeutic use*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000523:psychology; D016009:Chi-Square Distribution; D015897:Comorbidity; D003866:Depressive Disorder / Q000188:drug therapy* / Q000453:epidemiology; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D004700:Endocrine System Diseases / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales
chemical_list: D000928:Antidepressive Agents