title: Stressful life events, cognitive symptoms of depression and response to antidepressants in GENDEP.
abstract: BACKGROUND
  The occurrence of stressful life events (SLEs) has been shown to predict response to antidepressants; however, results are inconsistent. There is some evidence to suggest that SLEs prior to treatment are associated with greater cognitive symptoms at baseline and may therefore predict changes in these symptoms specifically.
  
  
  METHODS
  GENDEP, a prospective part-randomised pharmacogenomics trial, collected longitudinal data on the symptoms of patients with major depression treated with either a selective serotonin reuptake inhibitor (SSRI, escitalopram) or a tricyclic antidepressant (TCA, nortriptyline). Data on life events experienced in the 6 months preceding treatment measured using the List of Threatening Experiences Questionnaire (LTE-Q) were available for 728 participants.
  
  
  RESULTS
  Both the occurrence and number of SLEs were associated with greater cognitive but not mood or neurovegetative symptoms prior to treatment. Those who reported SLEs also experienced a greater decline in cognitive symptoms during treatment with escitalopram, but not with nortriptyline.
  
  
  CONCLUSIONS
  Life events were measured retrospectively using a self-report checklist and are therefore subject to a number of biases especially in the context of depressive illness.
  
  
  CONCLUSIONS
  These findings are in line with cognitive theories of depression and suggest that symptomatic heterogeneity may have contributed to inconsistencies in studies reported to date. Our results also tentatively suggest a clinically relevant drug specific effect of SLEs. Specifically, those reporting stress may benefit more from treatment with SSRIs than TCAs.
authors.affiliation: MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK. robert.keers@kcl.ac.uk
authors.forename: Robert
authors.initials: R
authors.lastname: Keers
authors.forename: Rudolf
authors.initials: R
authors.lastname: Uher
authors.forename: Bhanu
authors.initials: B
authors.lastname: Gupta
authors.forename: Marcella
authors.initials: M
authors.lastname: Rietschel
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Schulze
authors.forename: Joanna
authors.initials: J
authors.lastname: Hauser
authors.forename: Maria
authors.initials: M
authors.lastname: Skibinska
authors.forename: Neven
authors.initials: N
authors.lastname: Henigsberg
authors.forename: Petra
authors.initials: P
authors.lastname: Kalember
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Maier
authors.forename: Astrid
authors.initials: A
authors.lastname: Zobel
authors.forename: Ole
authors.initials: O
authors.lastname: Mors
authors.forename: Ann S
authors.initials: AS
authors.lastname: Kristensen
authors.forename: Dejan
authors.initials: D
authors.lastname: Kozel
authors.forename: Caterina
authors.initials: C
authors.lastname: Giovannini
authors.forename: Julien
authors.initials: J
authors.lastname: Mendlewicz
authors.forename: Sudhir
authors.initials: S
authors.lastname: Kumar
authors.forename: Peter
authors.initials: P
authors.lastname: McGuffin
authors.forename: Anne E
authors.initials: AE
authors.lastname: Farmer
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Aitchison
mesh_terms: D000328:Adult; D000339:Affect / Q000187:drug effects; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D003072:Cognition Disorders / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology*; D003865:Major Depressive Disorder / Q000188:drug therapy* / Q000235:genetics / Q000523:psychology*; D005260:Female; D006801:Humans; D008016:Life Change Events; D008137:Longitudinal Studies; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009661:Nortriptyline / Q000627:therapeutic use*; D010597:Pharmacogenetics
chemical_list: D018687:Antidepressive Agents, Second-Generation; D000929:Antidepressive Agents, Tricyclic; D015283:Citalopram; D009661:Nortriptyline