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Association between psychomotor disturbance and treatment outcome in psychotic depression: a STOP-PD II report

Published online by Cambridge University Press:  26 March 2021

Alastair J. Flint Open the ORCID record for Alastair J. Flint [Opens in a new window] ,
Kathleen S. Bingham ,
Nicholas H. Neufeld ,
George S. Alexopoulos ,
Benoit H. Mulsant ,
Anthony J. Rothschild ,
Ellen M. Whyte ,
Aristotle N. Voineskos ,
Patricia Marino  and
Barnett S. Meyers
Alastair J. Flint*
Affiliation:
The Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Mental Health, University Health Network, Toronto, Canada
Kathleen S. Bingham
Affiliation:
The Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Mental Health, University Health Network, Toronto, Canada Centre for Addiction and Mental Health, Toronto, Canada
Nicholas H. Neufeld
Affiliation:
The Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Addiction and Mental Health, Toronto, Canada
George S. Alexopoulos
Affiliation:
Department of Psychiatry, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, Westchester Division, New York, NY, USA
Benoit H. Mulsant
Affiliation:
The Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Addiction and Mental Health, Toronto, Canada
Anthony J. Rothschild
Affiliation:
University of Massachusetts Medical School and UMass Memorial Health Care, Worcester, MA, USA
Ellen M. Whyte
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine and UPMC Western Psychiatric Hospital, Pittsburgh, PA, USA
Aristotle N. Voineskos
Affiliation:
The Department of Psychiatry, University of Toronto, Toronto, Canada Centre for Addiction and Mental Health, Toronto, Canada
Patricia Marino
Affiliation:
Department of Psychiatry, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, Westchester Division, New York, NY, USA
Barnett S. Meyers
Affiliation:
Department of Psychiatry, Weill Cornell Medicine of Cornell University and New York Presbyterian Hospital, Westchester Division, New York, NY, USA
*
Author for correspondence: Alastair J. Flint, Email: alastair.flint@uhn.ca
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Abstract

Background

Little is known about the relationship between psychomotor disturbance (PMD) and treatment outcome of psychotic depression. This study examined the association between PMD and subsequent remission and relapse of treated psychotic depression.

Methods

Two hundred and sixty-nine men and women aged 18–85 years with an episode of psychotic depression were treated with open-label sertraline plus olanzapine for up to 12 weeks. Participants who remained in remission or near-remission following an 8-week stabilization phase were eligible to participate in a 36-week randomized controlled trial (RCT) that compared the efficacy and tolerability of sertraline plus olanzapine (n = 64) with sertraline plus placebo (n = 62). PMD was measured with the psychiatrist-rated sign-based CORE at acute phase baseline and at RCT baseline. Spearman's correlations and logistic regression analyses were used to analyze the association between CORE total score at acute phase baseline and remission/near-remission and CORE total score at RCT baseline and relapse.

Results

Higher CORE total score at acute phase baseline was associated with lower frequency of remission/near-remission. Higher CORE total score at RCT baseline was associated with higher frequency of relapse, in the RCT sample as a whole, as well as in each of the two randomized groups.

Conclusions

PMD is associated with poorer outcome of psychotic depression treated with sertraline plus olanzapine. Future research needs to examine the neurobiology of PMD in psychotic depression in relation to treatment outcome.

Keywords

CORE measurepsychomotor disturbancepsychotic depressionrelapseremissiontreatment
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 16 , December 2022 , pp. 3957 - 3963
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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