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Behavioral Sciences
Volume 12
Issue 2
10.3390/bs12020034
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Article

Clinical and Biological Factors Are Associated with Treatment-Resistant Depression

by
Massimiliano Buoli
1,2,†,
Enrico Capuzzi
3,†,
Alice Caldiroli
3,
Alessandro Ceresa
1,2,*,
Cecilia Maria Esposito
1,2,
Cristina Posio
1,
Anna Maria Auxilia
4,
Martina Capellazzi
4,
Ilaria Tagliabue
4,
Teresa Surace
1,2,3,
Francesca Legnani
1,2,
Luisa Cirella
1,
Martina Di Paolo
1,2,
Guido Nosari
1,
Francesco Zanelli Quarantini
1,
Massimo Clerici
3,4,
Fabrizia Colmegna
3 and
Antonios Dakanalis
4
1
Department of Neurosciences and Mental Health, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
2
Department of Pathophysiology and Transplantation, University of Milan, 20122 Milan, Italy
3
Psychiatric Department, Azienda Socio-Sanitaria Territoriale Monza, 20900 Monza, Italy
4
Department of Medicine and Surgery, University of Milano Bicocca, 20900 Monza, Italy
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to the manuscript.
Behav. Sci. 2022, 12(2), 34; https://doi.org/10.3390/bs12020034
Submission received: 13 December 2021 / Revised: 19 January 2022 / Accepted: 29 January 2022 / Published: 3 February 2022
Versions Notes

Abstract

Background: Treatment-resistant depression (TRD) is a debilitating condition associated with unmet clinical needs. Few studies have explored clinical characteristics and serum biomarkers associated with TRD. Aims: We investigated whether there were differences in clinical and biochemical variables between patients affected by TRD than those without. Methods: We recruited 343 patients (165 males and 178 females) consecutively hospitalized for MDD to the inpatient clinics affiliated to the Fondazione IRCCS Policlinico, Milan, Italy (n = 234), and ASST Monza, Italy (n = 109). Data were obtained through a screening of the clinical charts and blood analyses conducted during the hospitalization. Results: TRD versus non-TRD patients resulted to be older (p = 0.001), to have a longer duration of illness (p < 0.001), to be more currently treated with a psychiatric poly-therapy (p < 0.001), to have currently more severe depressive symptoms as showed by the Hamilton Depression Rating Scale (HAM-D) scores (p = 0.016), to have lower bilirubin plasma levels (p < 0.001). In addition, more lifetime suicide attempts (p = 0.035), more antidepressant treatments before the current episode (p < 0.001), and a lower neutrophil to lymphocyte ratio at borderline statistically significant level (p = 0.060) were all associated with the TRD group. Conclusion: We identified candidate biomarkers associated with TRD such as bilirubin plasma levels and NLR, to be confirmed by further studies. Moreover, TRD seems to be associated with unfavorable clinical factors such as a predisposition to suicidal behaviors. Future research should replicate these results to provide robust data in support of the identification of new targets of treatment and implementation of prevention strategies for TRD.
Keywords: Major Depressive Disorder (MDD); treatment-resistant depression (TRD); clinical features; biochemical markers Major Depressive Disorder (MDD); treatment-resistant depression (TRD); clinical features; biochemical markers

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MDPI and ACS Style

Buoli, M.; Capuzzi, E.; Caldiroli, A.; Ceresa, A.; Esposito, C.M.; Posio, C.; Auxilia, A.M.; Capellazzi, M.; Tagliabue, I.; Surace, T.; et al. Clinical and Biological Factors Are Associated with Treatment-Resistant Depression. Behav. Sci. 2022, 12, 34. https://doi.org/10.3390/bs12020034

AMA Style

Buoli M, Capuzzi E, Caldiroli A, Ceresa A, Esposito CM, Posio C, Auxilia AM, Capellazzi M, Tagliabue I, Surace T, et al. Clinical and Biological Factors Are Associated with Treatment-Resistant Depression. Behavioral Sciences. 2022; 12(2):34. https://doi.org/10.3390/bs12020034

Chicago/Turabian Style

Buoli, Massimiliano, Enrico Capuzzi, Alice Caldiroli, Alessandro Ceresa, Cecilia Maria Esposito, Cristina Posio, Anna Maria Auxilia, Martina Capellazzi, Ilaria Tagliabue, Teresa Surace, and et al. 2022. "Clinical and Biological Factors Are Associated with Treatment-Resistant Depression" Behavioral Sciences 12, no. 2: 34. https://doi.org/10.3390/bs12020034

APA Style

Buoli, M., Capuzzi, E., Caldiroli, A., Ceresa, A., Esposito, C. M., Posio, C., Auxilia, A. M., Capellazzi, M., Tagliabue, I., Surace, T., Legnani, F., Cirella, L., Di Paolo, M., Nosari, G., Zanelli Quarantini, F., Clerici, M., Colmegna, F., & Dakanalis, A. (2022). Clinical and Biological Factors Are Associated with Treatment-Resistant Depression. Behavioral Sciences, 12(2), 34. https://doi.org/10.3390/bs12020034

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