title: Anhedonia predicts poorer recovery among youth with selective serotonin reuptake inhibitor treatment-resistant depression.
abstract: OBJECTIVE
  To identify symptom dimensions of depression that predict recovery among selective serotonin reuptake inhibitor (SSRI) treatment-resistant adolescents undergoing second-step treatment.
  
  
  METHODS
  The Treatment of Resistant Depression in Adolescents (TORDIA) trial included 334 SSRI treatment-resistant youth randomized to a medication switch, or a medication switch plus CBT. This study examined five established symptom dimensions (Child Depression Rating Scale-Revised) at baseline as they predicted recovery over 24 weeks of acute and continuation treatment. The two indices of recovery that were evaluated were time to remission and number of depression-free days.
  
  
  RESULTS
  Multivariate analyses examining all five depression symptom dimensions simultaneously indicated that anhedonia was the only dimension to predict a longer time to remission, and also the only dimension to predict fewer depression-free days. In addition, when anhedonia and CDRS-total score were evaluated simultaneously, anhedonia continued to uniquely predict longer time to remission and fewer depression-free days.
  
  
  CONCLUSIONS
  Anhedonia may represent an important negative prognostic indicator among treatment-resistant depressed adolescents. Further research is needed to elucidate neurobehavioral underpinnings of anhedonia, and to test treatments that target anhedonia in the context of overall treatment of depression.
authors.affiliation: University of Pittsburgh, Western PsychiatricInstitute and Clinic, 3811 O’Hara Street, Pittsburgh, PA 15213, USA. mcmakind@upmc.edu
authors.forename: Dana L
authors.initials: DL
authors.lastname: McMakin
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Olino
authors.forename: Giovanna
authors.initials: G
authors.lastname: Porta
authors.forename: Laura J
authors.initials: LJ
authors.lastname: Dietz
authors.forename: Graham
authors.initials: G
authors.lastname: Emslie
authors.forename: Gregory
authors.initials: G
authors.lastname: Clarke
authors.forename: Karen Dineen
authors.initials: KD
authors.lastname: Wagner
authors.forename: Joan R
authors.initials: JR
authors.lastname: Asarnow
authors.forename: Neal D
authors.initials: ND
authors.lastname: Ryan
authors.forename: Boris
authors.initials: B
authors.lastname: Birmaher
authors.forename: Wael
authors.initials: W
authors.lastname: Shamseddeen
authors.forename: Taryn
authors.initials: T
authors.lastname: Mayes
authors.forename: Betsy
authors.initials: B
authors.lastname: Kennard
authors.forename: Anthony
authors.initials: A
authors.lastname: Spirito
authors.forename: Martin
authors.initials: M
authors.lastname: Keller
authors.forename: Frances L
authors.initials: FL
authors.lastname: Lynch
authors.forename: John F
authors.initials: JF
authors.lastname: Dickerson
authors.forename: David A
authors.initials: DA
authors.lastname: Brent
mesh_terms: D000293:Adolescent; D000339:Affect / Q000187:drug effects; D059445:Anhedonia / Q000187:drug effects*; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003511:Cyclohexanols / Q000009:adverse effects / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D061218:Depressive Disorder, Treatment-Resistant / Q000175:diagnosis* / Q000188:drug therapy* / Q000523:psychology; D004311:Double-Blind Method; D004351:Drug Resistance; D057915:Drug Substitution; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D010552:Personality Assessment / Q000706:statistics & numerical data; D011594:Psychometrics; D011613:Psychotherapy; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D000069470:Venlafaxine Hydrochloride
chemical_list: D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride