The relationship between early changes in the HAMD-17 anxiety/somatization factor items and treatment outcome among depressed outpatients

Amy Farabaugh, David Mischoulon, Maurizio Fava, Shirley L. Wu, Alessandra Mascarini, Eliana Tossani, Jonathan E. Alpert

Research output: Contribution to journalArticle

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Abstract

The 17-item Hamilton Rating Scale for Depression (HAMD-17) Anxiety/Somatization factor includes six items: Anxiety (psychic), Anxiety (somatic), Somatic Symptoms (gastrointestinal), Somatic Symptoms (general), Hypochondriasis and Insight. This study examines the relationship between early changes (defined as those observed between baseline and week 1) in these HAMD-17 Anxiety/Somatization Factor items and treatment outcome among major depressive disorder (MDD) patients who participated in a study comparing the antidepressant efficacy of a standardized extract of hypericum with both placebo and fluoxetine. Following a 1-week, single-blind washout, patients with MDD diagnosed by the Structured Clinical Interview for DSM-IV (SCID) were randomized to 12 weeks of double-blind treatment with hypericum extract (900 mg/day), fluoxetine (20 mg/day) or placebo. The relationship between early changes in HAMD-17 anxiety/ somatization factor items and treatment outcome was assessed separately for patients who received study treatment (hypericum or fluoxetine) versus placebo with a logistic regression method. One hundred and thirty-five patients (female 57%, mean age = 37.3 ± 11.0 years; mean baseline HAMD-17 = 19.7 ± 3.2 years) were randomized to double-blind treatment and were included in the intent-to-treat (ITT) analyses. After adjusting for baseline HAMD-17 scores and for multiple comparisons with the Bonferroni correction, patients who remitted (HAMD-17 score <8) after study treatment had significantly greater early improvement in Somatic Symptoms (General) scores than non-remitters. No other significant differences in early changes were noted for the remaining items between remitters versus non-remitters who received active treatment. For patients treated with placebo, early change was not predictive of remission for any of the items after Bonferroni correction. In conclusion, the presence of early improvement on the HAMD-17 item concerning fatigue and general somatic symptoms is significantly predictive of achieving remission at endpoint with active study treatment but not with placebo.

Original languageEnglish (US)
Pages (from-to)87-91
Number of pages5
JournalInternational Clinical Psychopharmacology
Volume20
Issue number2
DOIs
StatePublished - Mar 2005
Externally publishedYes

Fingerprint

Outpatients
Anxiety
Hypericum
Placebos
Fluoxetine
Major Depressive Disorder
Therapeutics
Hypochondriasis
Diagnostic and Statistical Manual of Mental Disorders
Antidepressive Agents
Fatigue
Logistic Models
Interviews
Depression
Medically Unexplained Symptoms

Keywords

  • Depression
  • Hamilton Rating Scale for Depression (HAMD-17)
  • Treatment outcome

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Pharmacology (medical)
  • Neuroscience(all)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

The relationship between early changes in the HAMD-17 anxiety/somatization factor items and treatment outcome among depressed outpatients. / Farabaugh, Amy; Mischoulon, David; Fava, Maurizio; Wu, Shirley L.; Mascarini, Alessandra; Tossani, Eliana; Alpert, Jonathan E.

In: International Clinical Psychopharmacology, Vol. 20, No. 2, 03.2005, p. 87-91.

Research output: Contribution to journalArticle

Farabaugh, Amy ; Mischoulon, David ; Fava, Maurizio ; Wu, Shirley L. ; Mascarini, Alessandra ; Tossani, Eliana ; Alpert, Jonathan E. / The relationship between early changes in the HAMD-17 anxiety/somatization factor items and treatment outcome among depressed outpatients. In: International Clinical Psychopharmacology. 2005 ; Vol. 20, No. 2. pp. 87-91.
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