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What next? A Bayesian hierarchical modeling re-examination of treatments for adolescents with selective serotonin reuptake inhibitor-resistant depression.

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Title: What next? A Bayesian hierarchical modeling re-examination of treatments for adolescents with selective serotonin reuptake inhibitor-resistant depression.
Authors: Suresh, Vikram (AUTHOR), Mills, Jeffrey A. (AUTHOR), Croarkin, Paul E. (AUTHOR), Strawn, Jeffrey R. (AUTHOR)
Source: Depression & Anxiety (1091-4269). Sep2020, Vol. 37 Issue 9, p926-934. 9p. 1 Diagram, 1 Chart, 2 Graphs.
Subjects: Monte Carlo method, Serotonin uptake inhibitors, Fixed effects model, Random effects model, Depression in adolescence, Cognitive therapy, Fluoxetine, Research, Research methodology, Evaluation research, Medical cooperation, Treatment effectiveness, Comparative studies, Mental depression, Research funding, Alcohols (Chemical class), Probability theory
Abstract: Background: Psychiatrists frequently struggle with how to sequence treatment for depressed adolescents who do not respond to an adequate trial of a selective serotonin reuptake inhibitor (SSRI). This study leveraged recent statistical and computational advances to create Bayesian hierarchal models (BHMs) of response in the treatment of SSRI-resistant depression in adolescents study to inform treatment planning.Methods: BHMs of individual treatment trajectories were developed and estimated using Hamiltonian Monte Carlo no u-turn sampling. From the Monte Carlo pseudorandom sample, 95% credible intervals, means, posterior tail probabilities, and so forth, were determined. Then, for the random effects model, posterior tail probabilities were used to create Bayesian two-tailed p values to evaluate the null hypotheses: no difference in efficacy between SSRIs and venlafaxine. The robustness of the results was examined using the fixed effects model of treatment comparisons.Results: In patients not receiving cognitive behavioral therapy (CBT; n = 168), SSRIs produced greater and faster improvement in depressive symptoms compared to venlafaxine (p = .015). No differences in response or trajectory of response for symptoms of anxiety were detected between SSRIs and venlafaxine (p = .168). For patients receiving CBT (n = 162), SSRIs and venlafaxine produced similar improvements in symptoms of anxiety and depression.Conclusions: Findings from this novel computational approach suggest that a second trial of an SSRI is warranted for depressed adolescents who fail to respond to initial SSRI treatment. [ABSTRACT FROM AUTHOR]
Copyright of Depression & Anxiety (1091-4269) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: What next? A Bayesian hierarchical modeling re-examination of treatments for adolescents with selective serotonin reuptake inhibitor-resistant depression.
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  Data: <searchLink fieldCode="AR" term="%22Suresh%2C+Vikram%22">Suresh, Vikram</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mills%2C+Jeffrey+A%2E%22">Mills, Jeffrey A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Croarkin%2C+Paul+E%2E%22">Croarkin, Paul E.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Strawn%2C+Jeffrey+R%2E%22">Strawn, Jeffrey R.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Depression+%26+Anxiety+%281091-4269%29%22">Depression & Anxiety (1091-4269)</searchLink>. Sep2020, Vol. 37 Issue 9, p926-934. 9p. 1 Diagram, 1 Chart, 2 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Monte+Carlo+method%22">Monte Carlo method</searchLink><br /><searchLink fieldCode="DE" term="%22Serotonin+uptake+inhibitors%22">Serotonin uptake inhibitors</searchLink><br /><searchLink fieldCode="DE" term="%22Fixed+effects+model%22">Fixed effects model</searchLink><br /><searchLink fieldCode="DE" term="%22Random+effects+model%22">Random effects model</searchLink><br /><searchLink fieldCode="DE" term="%22Depression+in+adolescence%22">Depression in adolescence</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+therapy%22">Cognitive therapy</searchLink><br /><searchLink fieldCode="DE" term="%22Fluoxetine%22">Fluoxetine</searchLink><br /><searchLink fieldCode="DE" term="%22Research%22">Research</searchLink><br /><searchLink fieldCode="DE" term="%22Research+methodology%22">Research methodology</searchLink><br /><searchLink fieldCode="DE" term="%22Evaluation+research%22">Evaluation research</searchLink><br /><searchLink fieldCode="DE" term="%22Medical+cooperation%22">Medical cooperation</searchLink><br /><searchLink fieldCode="DE" term="%22Treatment+effectiveness%22">Treatment effectiveness</searchLink><br /><searchLink fieldCode="DE" term="%22Comparative+studies%22">Comparative studies</searchLink><br /><searchLink fieldCode="DE" term="%22Mental+depression%22">Mental depression</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Alcohols+%28Chemical+class%29%22">Alcohols (Chemical class)</searchLink><br /><searchLink fieldCode="DE" term="%22Probability+theory%22">Probability theory</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: <bold>Background: </bold>Psychiatrists frequently struggle with how to sequence treatment for depressed adolescents who do not respond to an adequate trial of a selective serotonin reuptake inhibitor (SSRI). This study leveraged recent statistical and computational advances to create Bayesian hierarchal models (BHMs) of response in the treatment of SSRI-resistant depression in adolescents study to inform treatment planning.<bold>Methods: </bold>BHMs of individual treatment trajectories were developed and estimated using Hamiltonian Monte Carlo no u-turn sampling. From the Monte Carlo pseudorandom sample, 95% credible intervals, means, posterior tail probabilities, and so forth, were determined. Then, for the random effects model, posterior tail probabilities were used to create Bayesian two-tailed p values to evaluate the null hypotheses: no difference in efficacy between SSRIs and venlafaxine. The robustness of the results was examined using the fixed effects model of treatment comparisons.<bold>Results: </bold>In patients not receiving cognitive behavioral therapy (CBT; n = 168), SSRIs produced greater and faster improvement in depressive symptoms compared to venlafaxine (p = .015). No differences in response or trajectory of response for symptoms of anxiety were detected between SSRIs and venlafaxine (p = .168). For patients receiving CBT (n = 162), SSRIs and venlafaxine produced similar improvements in symptoms of anxiety and depression.<bold>Conclusions: </bold>Findings from this novel computational approach suggest that a second trial of an SSRI is warranted for depressed adolescents who fail to respond to initial SSRI treatment. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Depression & Anxiety (1091-4269) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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        Value: 10.1002/da.23064
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        Text: English
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        PageCount: 9
        StartPage: 926
    Subjects:
      – SubjectFull: Monte Carlo method
        Type: general
      – SubjectFull: Serotonin uptake inhibitors
        Type: general
      – SubjectFull: Fixed effects model
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      – SubjectFull: Fluoxetine
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      – SubjectFull: Mental depression
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      – SubjectFull: Research funding
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      – SubjectFull: Alcohols (Chemical class)
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      – SubjectFull: Probability theory
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      – TitleFull: What next? A Bayesian hierarchical modeling re-examination of treatments for adolescents with selective serotonin reuptake inhibitor-resistant depression.
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              Text: Sep2020
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