Cause-specific life years lost in individuals with treatment-resistant depression: A Danish nationwide register-based cohort study

Kathrine Bang Madsen; Oleguer Plana-Ripoll; Katherine L Musliner; Jean-Christophe Philippe Debost; Liselotte Vogdrup Petersen; Trine Munk-Olsen

doi:10.1016/j.jad.2020.11.042

Cause-specific life years lost in individuals with treatment-resistant depression: A Danish nationwide register-based cohort study

Kathrine Bang Madsen, Oleguer Plana-Ripoll, Katherine L Musliner, Jean-Christophe Philippe Debost, Liselotte Vogdrup Petersen, Trine Munk-Olsen

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

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Abstract

BACKGROUND: Depression is associated with excess mortality, but it is not known how treatment-resistance influences life expectancy. We estimated cause-specific excess mortality and Life Years Lost (LYL) in patients with treatment-resistant depression (TRD).

METHODS: The population included all individuals born and living in Denmark who redeemed their first prescription for an antidepressant at age 18-69 years between 2005 and 2012, identified in the Danish National Prescription Registry. TRD was defined as at least two additional and different antidepressant trials within two years. Mortality rate ratios (MRRs) were estimated with Cox regression adjusted for age at first prescription, calendar year and comorbidity. Differences in life expectancy were estimated by the Life Years Lost (LYL) method.

RESULTS: The cohort included 154,513 first-time pharmacologically treated patients with depression, of whom 8,294 (5.4%) were identified as having TRD. Patients were followed for 1,032,245 person-years during which 9,795 deaths occurred. Men and women with TRD had significantly higher mortality than non-TRD (aMRR: 1.34, 95% CI 1.18-1.52 and aMRR: 1.39, 95% CI 1.19-1.63, respectively). Life expectancy for men and women with TRD was 1.21 (95% CI 0.36-2.44) and 1.24 (95% CI 0.35-2.34) years shorter than in all patients with depression. Suicide accounted for the majority of excess LYL, with 1.10 (95% CI 0.46-1.61) years in men and 0.82 (95% CI 0.44-1.27) years in women with TRD.

LIMITATIONS: Using redeemed prescriptions to define TRD may increase the risk of misclassification.

CONCLUSIONS: Patients not responding adequately to several treatment trials are at increased risk for premature death, particularly suicide.

Originalsprog	Engelsk
Tidsskrift	Journal of Affective Disorders
Vol/bind	280
Nummer	Part A
Sider (fra-til)	250-257
Antal sider	8
ISSN	0165-0327
DOI	https://doi.org/10.1016/j.jad.2020.11.042
Status	Udgivet - feb. 2021

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10.1016/j.jad.2020.11.042Licens: CC BY-NC-ND

Bang Madsen et al. 2020- mortalityLicens: CC BY-NC-ND

Citationsformater

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title = "Cause-specific life years lost in individuals with treatment-resistant depression: A Danish nationwide register-based cohort study",

abstract = "BACKGROUND: Depression is associated with excess mortality, but it is not known how treatment-resistance influences life expectancy. We estimated cause-specific excess mortality and Life Years Lost (LYL) in patients with treatment-resistant depression (TRD).METHODS: The population included all individuals born and living in Denmark who redeemed their first prescription for an antidepressant at age 18-69 years between 2005 and 2012, identified in the Danish National Prescription Registry. TRD was defined as at least two additional and different antidepressant trials within two years. Mortality rate ratios (MRRs) were estimated with Cox regression adjusted for age at first prescription, calendar year and comorbidity. Differences in life expectancy were estimated by the Life Years Lost (LYL) method.RESULTS: The cohort included 154,513 first-time pharmacologically treated patients with depression, of whom 8,294 (5.4%) were identified as having TRD. Patients were followed for 1,032,245 person-years during which 9,795 deaths occurred. Men and women with TRD had significantly higher mortality than non-TRD (aMRR: 1.34, 95% CI 1.18-1.52 and aMRR: 1.39, 95% CI 1.19-1.63, respectively). Life expectancy for men and women with TRD was 1.21 (95% CI 0.36-2.44) and 1.24 (95% CI 0.35-2.34) years shorter than in all patients with depression. Suicide accounted for the majority of excess LYL, with 1.10 (95% CI 0.46-1.61) years in men and 0.82 (95% CI 0.44-1.27) years in women with TRD.LIMITATIONS: Using redeemed prescriptions to define TRD may increase the risk of misclassification.CONCLUSIONS: Patients not responding adequately to several treatment trials are at increased risk for premature death, particularly suicide.",

keywords = "Antidepressants, Life years lost, Mortality, Suicide, Treatment-resistant depression",

author = "Madsen, {Kathrine Bang} and Oleguer Plana-Ripoll and Musliner, {Katherine L} and Debost, {Jean-Christophe Philippe} and Petersen, {Liselotte Vogdrup} and Trine Munk-Olsen",

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year = "2021",

month = feb,

doi = "10.1016/j.jad.2020.11.042",

language = "English",

volume = "280",

pages = "250--257",

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Cause-specific life years lost in individuals with treatment-resistant depression: A Danish nationwide register-based cohort study. / Madsen, Kathrine Bang ; Plana-Ripoll, Oleguer ; Musliner, Katherine L et al.
I: Journal of Affective Disorders, Bind 280, Nr. Part A, 02.2021, s. 250-257.

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avis › Tidsskriftartikel › Forskning › peer review

TY - JOUR

T1 - Cause-specific life years lost in individuals with treatment-resistant depression

T2 - A Danish nationwide register-based cohort study

AU - Madsen, Kathrine Bang

AU - Plana-Ripoll, Oleguer

AU - Musliner, Katherine L

AU - Debost, Jean-Christophe Philippe

AU - Petersen, Liselotte Vogdrup

AU - Munk-Olsen, Trine

PY - 2021/2

Y1 - 2021/2

N2 - BACKGROUND: Depression is associated with excess mortality, but it is not known how treatment-resistance influences life expectancy. We estimated cause-specific excess mortality and Life Years Lost (LYL) in patients with treatment-resistant depression (TRD).METHODS: The population included all individuals born and living in Denmark who redeemed their first prescription for an antidepressant at age 18-69 years between 2005 and 2012, identified in the Danish National Prescription Registry. TRD was defined as at least two additional and different antidepressant trials within two years. Mortality rate ratios (MRRs) were estimated with Cox regression adjusted for age at first prescription, calendar year and comorbidity. Differences in life expectancy were estimated by the Life Years Lost (LYL) method.RESULTS: The cohort included 154,513 first-time pharmacologically treated patients with depression, of whom 8,294 (5.4%) were identified as having TRD. Patients were followed for 1,032,245 person-years during which 9,795 deaths occurred. Men and women with TRD had significantly higher mortality than non-TRD (aMRR: 1.34, 95% CI 1.18-1.52 and aMRR: 1.39, 95% CI 1.19-1.63, respectively). Life expectancy for men and women with TRD was 1.21 (95% CI 0.36-2.44) and 1.24 (95% CI 0.35-2.34) years shorter than in all patients with depression. Suicide accounted for the majority of excess LYL, with 1.10 (95% CI 0.46-1.61) years in men and 0.82 (95% CI 0.44-1.27) years in women with TRD.LIMITATIONS: Using redeemed prescriptions to define TRD may increase the risk of misclassification.CONCLUSIONS: Patients not responding adequately to several treatment trials are at increased risk for premature death, particularly suicide.

AB - BACKGROUND: Depression is associated with excess mortality, but it is not known how treatment-resistance influences life expectancy. We estimated cause-specific excess mortality and Life Years Lost (LYL) in patients with treatment-resistant depression (TRD).METHODS: The population included all individuals born and living in Denmark who redeemed their first prescription for an antidepressant at age 18-69 years between 2005 and 2012, identified in the Danish National Prescription Registry. TRD was defined as at least two additional and different antidepressant trials within two years. Mortality rate ratios (MRRs) were estimated with Cox regression adjusted for age at first prescription, calendar year and comorbidity. Differences in life expectancy were estimated by the Life Years Lost (LYL) method.RESULTS: The cohort included 154,513 first-time pharmacologically treated patients with depression, of whom 8,294 (5.4%) were identified as having TRD. Patients were followed for 1,032,245 person-years during which 9,795 deaths occurred. Men and women with TRD had significantly higher mortality than non-TRD (aMRR: 1.34, 95% CI 1.18-1.52 and aMRR: 1.39, 95% CI 1.19-1.63, respectively). Life expectancy for men and women with TRD was 1.21 (95% CI 0.36-2.44) and 1.24 (95% CI 0.35-2.34) years shorter than in all patients with depression. Suicide accounted for the majority of excess LYL, with 1.10 (95% CI 0.46-1.61) years in men and 0.82 (95% CI 0.44-1.27) years in women with TRD.LIMITATIONS: Using redeemed prescriptions to define TRD may increase the risk of misclassification.CONCLUSIONS: Patients not responding adequately to several treatment trials are at increased risk for premature death, particularly suicide.

KW - Antidepressants

KW - Life years lost

KW - Mortality

KW - Suicide

KW - Treatment-resistant depression

U2 - 10.1016/j.jad.2020.11.042

DO - 10.1016/j.jad.2020.11.042

M3 - Journal article

C2 - 33220561

SN - 0165-0327

VL - 280

SP - 250

EP - 257

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

IS - Part A

ER -

Cause-specific life years lost in individuals with treatment-resistant depression: A Danish nationwide register-based cohort study

Abstract

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