TY - JOUR
T1 - Socioeconomic Predictors of Treatment Outcomes Among Adults With Major Depressive Disorder
AU - Mills, Jeffrey A.
AU - Suresh, Vikram
AU - Chang, Lenisa
AU - Mayes, Taryn
AU - Croarkin, Paul E.
AU - Trivedi, Madhukar H.
AU - Strawn, Jeffrey R.
N1 - Publisher Copyright:
© 2022 American Psychiatric Association. All rights reserved.
PY - 2022/9
Y1 - 2022/9
N2 - Objective: In this study, the authors sought to examine the impact of socioeconomic variables on outcomes of pharmacotherapy treatments for major depressive disorder in analyses that controlled for treatment access and level of care. Methods: The authors used data from the Combining Medications to Enhance Depression Outcomes study, a prospective clinical trial conducted from March 2008 to April 2014 with 665 adults who had major depressive disorder and were randomly assigned to three pharmacotherapeutic treatments, to develop Bayesian hierarchical models of treatment trajectories for change in Quick Inventory of Depressive Symptomatology–Self-Report ratings. Posterior tail probabilities were used to evaluate the effects of education, income, race-ethnicity, and employment on treatment outcomes. Results: After sex, age, and treatment type were controlled for in the analyses, not having a college education (,16 years of schooling), being unemployed, or being non-White were each associated with slower and less improvement. At the end of treatment (week 12), not having a college degree reduced treatment responses by 9.6% (p50.045), being unemployed by 6.6% (p50.007), and being non-White by 11.3% (p,0.001). Treatment response was significantly related to income; having an income at the 25th percentile of the income distribution decreased improvement by 4.8% compared with having an income at the 75th percentile (p50.018). Conclusions: Within a short-term, randomized controlled trial, socioeconomic factors had a critical role in the acute response of patients to pharmacotherapy for major depression.
AB - Objective: In this study, the authors sought to examine the impact of socioeconomic variables on outcomes of pharmacotherapy treatments for major depressive disorder in analyses that controlled for treatment access and level of care. Methods: The authors used data from the Combining Medications to Enhance Depression Outcomes study, a prospective clinical trial conducted from March 2008 to April 2014 with 665 adults who had major depressive disorder and were randomly assigned to three pharmacotherapeutic treatments, to develop Bayesian hierarchical models of treatment trajectories for change in Quick Inventory of Depressive Symptomatology–Self-Report ratings. Posterior tail probabilities were used to evaluate the effects of education, income, race-ethnicity, and employment on treatment outcomes. Results: After sex, age, and treatment type were controlled for in the analyses, not having a college education (,16 years of schooling), being unemployed, or being non-White were each associated with slower and less improvement. At the end of treatment (week 12), not having a college degree reduced treatment responses by 9.6% (p50.045), being unemployed by 6.6% (p50.007), and being non-White by 11.3% (p,0.001). Treatment response was significantly related to income; having an income at the 25th percentile of the income distribution decreased improvement by 4.8% compared with having an income at the 75th percentile (p50.018). Conclusions: Within a short-term, randomized controlled trial, socioeconomic factors had a critical role in the acute response of patients to pharmacotherapy for major depression.
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U2 - 10.1176/appi.ps.202100559
DO - 10.1176/appi.ps.202100559
M3 - Article
C2 - 35354325
AN - SCOPUS:85137138036
SN - 1075-2730
VL - 73
SP - 965
EP - 969
JO - Psychiatric Services
JF - Psychiatric Services
IS - 9
ER -