title: Stressful events, stress perception and treatment outcomes in patients with depressive disorders: the CRESCEND study.
abstract: BACKGROUND
  Investigations of associations between stressful events and depression treatment outcomes have led to conflicting findings. In a prospective naturalistic study of depression treatment we sought to investigate perceived stress as a predictor of 12-week antidepressant treatment outcome.
  
  
  METHODS
  A nationwide sample of 580 people with depressive disorders was recruited from 18 hospitals in Korea. Number of stressful events in the last 12 months and subjective perception of stress were ascertained, and were dichotomized by median values. Participants commenced on antidepressant treatment were re-evaluated at 1, 2, 4, 8, and 12 weeks later. Assessment scales for evaluating depression (HAMD), anxiety (HAMA), global severity (CGI-s), and functioning (SOFAS) were administered at baseline and at every follow-up visit. Covariates included pre-treatment socio-demographic and clinical characteristics, and treatment-related characteristics.
  
  
  RESULTS
  Higher baseline perceived stress was significantly associated with worse 12-week antidepressant treatment outcomes in terms of depression, anxiety, and global severity after adjustment for all covariates. However, baseline number of stressful events was not associated with any treatment outcomes.
  
  
  CONCLUSIONS
  The study was observational, and the treatment modality was naturalistic.
  
  
  CONCLUSIONS
  Depressive patients with higher level of perceived stress at the time of commencing treatment had less favorable outcomes after antidepressant treatment. This may represent a group requiring more specific assessment and more intensive management in order to improve treatment response.
authors.affiliation: Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea. jmkim@chonnam.ac.kr
authors.forename: Jae-Min
authors.initials: JM
authors.lastname: Kim
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
authors.forename: Robert
authors.initials: R
authors.lastname: Stewart
authors.forename: Hee-Ju
authors.initials: HJ
authors.lastname: Kang
authors.forename: Il-Seon
authors.initials: IS
authors.lastname: Shin
authors.forename: Sung-Won
authors.initials: SW
authors.lastname: Jung
authors.forename: Min-Soo
authors.initials: MS
authors.lastname: Lee
authors.forename: Hyeon-Woo
authors.initials: HW
authors.lastname: Yim
authors.forename: Tae-Youn
authors.initials: TY
authors.lastname: Jun
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003863:Depression; D003866:Depressive Disorder / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007723:Korea; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013315:Stress, Psychological; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents