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Symptom level analysis of recovery during antidepressant treatment








Symptom level analysis of recovery during antidepressant treatment


Markus Jokela


Department of Psychology and Logopedics, Medical Faculty, University of Helsinki, Helsinki, Finland






5 Aug 2019


The purpose of the current project is to examine whether specific symptoms of depression respond differently to antidepressant treatment among individuals diagnosed with clinical depression. Antidepressant medication are known to decrease symptoms of depression in most, but not all, patients. This produces a heterogeneous treatment response in clinical trials, as the treatment works only on some patients. One potential reason for this heterogeneity in treatment response is the specific combination and profile of the person's depressive symptoms. Whereas depression symptoms have been traditionally considered as interchangeable indicators of the underlying disease, the symptoms can produce multiple variations of depression and there are hundreds of possible symptom combinations by which a diagnosis threshold of depression can be reached.The present project tests whether symptoms of depression are differently improved by treatment, and whether improvements in specific symptoms are more important than others in predicting improvements in other symptoms. We hypothesize that specific symptoms are differently influenced by treatment, and that the profile of specific symptoms, and not just the overall level of symptoms, can be used to predict a person's treatment response. Furthermore, we hypothesize that there are symptom cascades where a change in one symptom is required for a subsequent change in other symptoms to occur.A symptom-level understanding of antidepressant treatment may have clinical relevance in identifying symptom-level obstacles in treatment response and potential symptom-level obstacles among those with low response to antidepressant treatment. It would also help to better understand the psychological processes underlying antidepressant treatment, which has usually been assessed only at the level of depression sum scores instead of specific symptoms.



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Statistical Analysis Plan