A gender analysis of the study of pharmacotherapy of psychotic depression (STOP-PD): gender and age as predictors of response and treatment-associated changes in body mass index and metabolic measures.
BACKGROUND
Gender differences exist in psychiatric disorders; however, gender has not been well studied in psychotic depression. This analysis of the largest clinical trial in psychotic depression examined the effects of age and gender on clinical characteristics and predictors of treatment outcome and treatment-associated changes in body mass index (BMI) and metabolic measures.


METHODS
Secondary analyses were performed on data from 259 subjects with major depressive disorder with psychotic features (DSM-IV-TR) aged 18-93 years in the double-blind randomized controlled trial of olanzapine plus sertraline versus olanzapine plus placebo for psychotic depression (Study of Pharmacotherapy of Psychotic Depression). Sociodemographic factors, clinical characteristics, treatment outcome, and treatment-associated changes in BMI and metabolic measures were analyzed by gender and age. Subjects were enrolled from December 2002 to June 2007.


RESULTS
Female gender was associated with divorced (χ(2)(1) = 5.3, P = .03) or widowed (χ(2)(1) = 8.1, P ≤ .01) marital status. Comorbid anxiety disorders were more common in women than in men (χ(2)(1) = 4.9, P = .03). Hallucinations (χ(2)(1) = 7.8, P = .005) and delusions with disorganization (t(257) = -2.10, P = .04) were significantly associated with female gender, as were higher cholesterol measures (χ(2)(1) = 7.15, P = .008). There were no significant interactions between treatment and gender in terms of change in BMI. Gender was not associated with treatment response.


CONCLUSIONS
This study is the first analysis of gender and age as predictors of treatment outcome and treatment-associated changes in BMI and metabolic adverse effects in psychotic depression. Gender differences exist in patients with psychotic depression, most notably with regard to the presence of hallucinations. Female gender was associated with metabolic measures. Future studies with larger sample sizes may detect small gender differences in treatment outcome and treatment-associated changes in BMI and metabolic measures in psychotic depression.


BACKGROUND
ClinicalTrials.gov identifier: NCT00056472.
University of Massachusetts Medical School and University of Massachusetts Memorial Health Care, Worcester.
Kristina M
KM
Deligiannidis
Anthony J
AJ
Rothschild
Bruce A
BA
Barton
Aimee R
AR
Kroll-Desrosiers
Barnett S
BS
Meyers
Alastair J
AJ
Flint
Ellen M
EM
Whyte
Benoit H
BH
Mulsant
D000328:Adult; D000367:Age Factors; D000368:Aged; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects; D001569:Benzodiazepines / Q000008:administration & dosage / Q000009:adverse effects; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004311:Double-Blind Method; D016903:Drug Monitoring / Q000379:methods; D004359:Drug Therapy, Combination; D005260:Female; D006212:Hallucinations / Q000188:drug therapy; D006801:Humans; D008297:Male; D008660:Metabolism; D008875:Middle Aged; D000077152:Olanzapine; D017063:Outcome Assessment, Health Care; D011569:Psychiatric Status Rating Scales; D020280:Sertraline / Q000008:administration & dosage / Q000009:adverse effects; D012737:Sex Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D001569:Benzodiazepines; D000077152:Olanzapine; D020280:Sertraline