{"doi":"10.1371/journal.pone.0220763","title":"An episode level evaluation of the treatment journey of patients with major depressive disorder and treatment-resistant depression","abstract":null,"journal":"PLOS ONE","year":2019,"id":633892,"datarank":0.31191623125197543,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.0,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":284296,"name":"Qian Cai","orcid":"0000-0001-8525-2749","position":1,"is_corresponding":false},{"id":1643682,"name":"John J. Sheehan","orcid":"0000-0002-5045-5025","position":2,"is_corresponding":false},{"id":1643683,"name":"Carmela Benson","orcid":null,"position":3,"is_corresponding":false},{"id":1643685,"name":"Nancy Connolly","orcid":null,"position":4,"is_corresponding":false},{"id":1153111,"name":"Larry Alphs","orcid":"0000-0001-9991-6905","position":5,"is_corresponding":false},{"id":1273263,"name":"Bingcao Wu","orcid":"0000-0002-7027-8062","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"An episode level evaluation of the treatment journey of patients with major depressive disorder and treatment-resistant depression","abstract":"<h4>Background</h4>Many patients with major depressive disorder (MDD) fail to respond to antidepressant (AD) pharmacotherapy. The objectives of this study were to characterize MDD and treatment-resistant depression (TRD) at the level of pharmacologically treated episodes and to describe the sequential treatment patterns by lines of therapy (LOT) in the first two episodes.<h4>Methods</h4>Adults (≥18 years of age) with continuous enrollment ≥12 months before and after the first MDD diagnosis and treated with an AD, with or without an MDD-indicated antipsychotic (AP), were identified (1/1/2010-12/31/2015). The MDD episode started on the date of MDD diagnosis that was preceded by a clean period without any MDD diagnosis. The MDD episode ended on the last MDD diagnosis or the end of the days' supply of AD/AP medication, whichever came last. TRD was defined as an MDD episode with ≥3 AD/AP regimens. Measured outcomes included episode duration, number of LOT, relapse hospitalization, and sequential treatment patterns of MDD episode stratified by TRD and non-TRD episodes.<h4>Results</h4>Of 48,440 patients who received AD/AP in the 1st MDD episode, 3,317 (6.8%) of episodes were considered TRD. Mean duration of 1st TRD episodes was 571 days, mean number of AD/AP LOTs was 3.47, and 13.7% involved relapse hospitalization. Mean duration of 1st non-TRD episodes was 200 days, mean number of AD/AP LOTs was 1.21, and 9.6% involved relapse hospitalization. Among 1st MDD episodes, 25.5% had a second LOT; 7.3% had a third LOT. Most patients received selective serotonin reuptake inhibitors (SSRIs) as the first LOT (63.0%), and the plurality of regimens were SSRIs in second (44.9%) and third LOT (41.1%).<h4>Conclusions</h4>Compared to non-TRD episodes, TRD episodes were longer and more often involved relapse hospitalizations. SSRIs were the most common treatment; treatment changes and potential treatment unresponsiveness were frequent among MDD patients.","is_dataset_classified":null,"base_score":0.0,"endowment":0.0,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"31393922","pmcid":"PMC6687173","openalex_id":null,"authors":[],"funders":[{"funder_name":"Janssen Scientific Affairs, LLC","grant_id":"","title":null}],"total_grants":1,"fwci":null,"citation_percentile":null,"influential_citations":0,"citation_trend":[],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0220763&type=printable","host_type":"publisher"},{"url":"http://dx.plos.org/10.1371/journal.pone.0220763","host_type":"publisher"},{"url":"https://doaj.org/article/725f70e291a84d19a986aec794b77c1e","host_type":"repository"},{"url":"https://figshare.com/articles/journal_contribution/An_episode_level_evaluation_of_the_treatment_journey_of_patients_with_major_depressive_disorder_and_treatment-resistant_depression/9393494","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/6687173","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC6687173","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC6687173?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":[],"mesh_terms":["Humans","Antipsychotic Agents","Antidepressive Agents","Treatment Outcome","Hospitalization","Retrospective Studies","Adult","Middle Aged","Female","Male","Depressive Disorder, Treatment-Resistant","Selective Serotonin Reuptake Inhibitors","Major Depressive Disorder"],"keywords":[],"sdg_mappings":[],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[{"name":"doi"}],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T12:50:22.948822Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}