title: Changes in Depression Subtypes Among Men in STAR*D: A Latent Transition Analysis.
abstract: The burden of depression in men is high. Current diagnostic criteria may not fully capture men's experience with depression. Descriptions of the heterogeneity in depression among men are lacking. The purpose of the study was to characterize latent subtypes of major depression and changes in these subtypes among men receiving citalopram in Level 1 of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial. Latent transition analysis was applied to data from 387 men who completed baseline and Week 12 study visits in Level 1 of STAR*D. Items from the self-report version of the Quick Inventory of Depressive Symptomatology were used as indicators of latent depression subtypes. Four statuses were identified at baseline and Week 12. Baseline statuses were Mild (10% of men), Moderate (53%), Severe with Psychomotor Slowing (20%), and Severe with Psychomotor Agitation (17%). At Week 12, the statuses were Symptom Resolution (41%), Mild (36%), Moderate (18%), and Severe with Psychomotor Slowing (5%). Men in the Mild status were most likely to transition to Symptom Resolution (probability = 69%). Men in the Severe with Agitation status were least likely to transition to Symptom Resolution (probability = 0%). This work highlights the need to not focus solely on summary rating scores but to also consider patterns of symptoms when treating depression.
authors.affiliation: 1 University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Christine M
authors.initials: CM
authors.lastname: Ulbricht
authors.affiliation: 2 Temple University College of Public Health, Philadelphia, PA, USA.
authors.forename: Levent
authors.initials: L
authors.lastname: Dumenci
authors.affiliation: 1 University of Massachusetts Medical School, Worcester, MA, USA.|3 UMassMemorial HealthCare, Worcester, MA, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Rothschild
authors.affiliation: 1 University of Massachusetts Medical School, Worcester, MA, USA.
authors.forename: Kate L
authors.initials: KL
authors.lastname: Lapane
mesh_terms: D000328:Adult; D000367:Age Factors; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use*; D015283:Citalopram / Q000627:therapeutic use*; D015331:Cohort Studies; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000188:drug therapy* / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D054526:Men's Health; D009483:Neuropsychological Tests; D000071066:Patient Reported Outcome Measures; D018579:Patient Selection; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D014481:United States
chemical_list: D018687:Antidepressive Agents, Second-Generation; D015283:Citalopram
keywords: STAR*D; depression subtypes; latent transition analysis; major depressive disorder