Are depressed outpatients with and without a family history of substance use disorder different? A baseline analysis of the STAR*D cohort

Lori L. Davis, Elizabeth C. Frazier, Bradley N. Gaynes, Madhukar H. Trivedi, Stephen R. Wisniewski, Maurizio Fava, Jennifer Barkin, T. Michael Kashner, Richard C. Shelton, Jonathan E. Alpert, A. John Rush

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Objective: This report compares the baseline demographic and clinical characteristics of outpatients with nonpsychotic major depressive disorder (MDD) and a family history of substance use disorder (SUD) versus those with MDD and no family history of SUD. Method: Using data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, we grouped participants with MDD (DSM-IV criteria) according to presence or absence of family history of SUD based on participant report. Between-group comparisons were made of demographic and clinical characteristics, depressive symptoms, and psychiatric comorbidities. Patients were enrolled from July 2001 until August 2004. Results: Of 4010 participants, 46% had a positive family history of SUD. Those with a positive family history were less likely to be Hispanic (p = .0029) and more likely to be female (p = .0013). They were less educated (p = .0120), less likely to be married (p < .01), and more likely to be divorced (p < .01). They also reported an earlier age at onset of MDD, greater length of illness, and more major depressive episodes (all p < .001). They had an increased likelihood of recurrent MDD, more prior suicide attempts, and more concurrent psychiatric comorbidities, including posttraumatic stress disorder, SUD, and generalized anxiety disorder (all p < .0001). Conclusion: Depressed patients with a family history of SUD had a more severe previous course of depression, were more likely to have attempted suicide, and had a greater burden of psychiatric comorbid conditions than patients without such a family history. These findings represent important clinical features to be considered in the evaluation and treatment planning of patients with MDD.

Original languageEnglish (US)
Pages (from-to)1931-1938
Number of pages8
JournalJournal of Clinical Psychiatry
Volume68
Issue number12
StatePublished - Dec 2007
Externally publishedYes

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Major Depressive Disorder
Substance-Related Disorders
Outpatients
Depression
Psychiatry
Therapeutics
Comorbidity
Demography
Attempted Suicide
Divorce
Post-Traumatic Stress Disorders
Anxiety Disorders
Age of Onset
Hispanic Americans
Diagnostic and Statistical Manual of Mental Disorders
Suicide

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

Cite this

Davis, L. L., Frazier, E. C., Gaynes, B. N., Trivedi, M. H., Wisniewski, S. R., Fava, M., ... Rush, A. J. (2007). Are depressed outpatients with and without a family history of substance use disorder different? A baseline analysis of the STAR*D cohort. Journal of Clinical Psychiatry, 68(12), 1931-1938.

Are depressed outpatients with and without a family history of substance use disorder different? A baseline analysis of the STAR*D cohort. / Davis, Lori L.; Frazier, Elizabeth C.; Gaynes, Bradley N.; Trivedi, Madhukar H.; Wisniewski, Stephen R.; Fava, Maurizio; Barkin, Jennifer; Kashner, T. Michael; Shelton, Richard C.; Alpert, Jonathan E.; Rush, A. John.

In: Journal of Clinical Psychiatry, Vol. 68, No. 12, 12.2007, p. 1931-1938.

Research output: Contribution to journalArticle

Davis, LL, Frazier, EC, Gaynes, BN, Trivedi, MH, Wisniewski, SR, Fava, M, Barkin, J, Kashner, TM, Shelton, RC, Alpert, JE & Rush, AJ 2007, 'Are depressed outpatients with and without a family history of substance use disorder different? A baseline analysis of the STAR*D cohort', Journal of Clinical Psychiatry, vol. 68, no. 12, pp. 1931-1938.
Davis, Lori L. ; Frazier, Elizabeth C. ; Gaynes, Bradley N. ; Trivedi, Madhukar H. ; Wisniewski, Stephen R. ; Fava, Maurizio ; Barkin, Jennifer ; Kashner, T. Michael ; Shelton, Richard C. ; Alpert, Jonathan E. ; Rush, A. John. / Are depressed outpatients with and without a family history of substance use disorder different? A baseline analysis of the STAR*D cohort. In: Journal of Clinical Psychiatry. 2007 ; Vol. 68, No. 12. pp. 1931-1938.
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AU - Frazier, Elizabeth C.

AU - Gaynes, Bradley N.

AU - Trivedi, Madhukar H.

AU - Wisniewski, Stephen R.

AU - Fava, Maurizio

AU - Barkin, Jennifer

AU - Kashner, T. Michael

AU - Shelton, Richard C.

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N2 - Objective: This report compares the baseline demographic and clinical characteristics of outpatients with nonpsychotic major depressive disorder (MDD) and a family history of substance use disorder (SUD) versus those with MDD and no family history of SUD. Method: Using data from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study, we grouped participants with MDD (DSM-IV criteria) according to presence or absence of family history of SUD based on participant report. Between-group comparisons were made of demographic and clinical characteristics, depressive symptoms, and psychiatric comorbidities. Patients were enrolled from July 2001 until August 2004. Results: Of 4010 participants, 46% had a positive family history of SUD. Those with a positive family history were less likely to be Hispanic (p = .0029) and more likely to be female (p = .0013). They were less educated (p = .0120), less likely to be married (p < .01), and more likely to be divorced (p < .01). They also reported an earlier age at onset of MDD, greater length of illness, and more major depressive episodes (all p < .001). They had an increased likelihood of recurrent MDD, more prior suicide attempts, and more concurrent psychiatric comorbidities, including posttraumatic stress disorder, SUD, and generalized anxiety disorder (all p < .0001). Conclusion: Depressed patients with a family history of SUD had a more severe previous course of depression, were more likely to have attempted suicide, and had a greater burden of psychiatric comorbid conditions than patients without such a family history. These findings represent important clinical features to be considered in the evaluation and treatment planning of patients with MDD.

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