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Early change in reward and punishment sensitivity as a predictor of response to antidepressant treatment for major depressive disorder: a CAN-BIND-1 report

Published online by Cambridge University Press:  17 September 2018

Timothy A. Allen Open the ORCID record for Timothy A. Allen [Opens in a new window] ,
Raymond W. Lam ,
Roumen Milev ,
Sakina J. Rizvi ,
Benicio N. Frey ,
Glenda M. MacQueen ,
Daniel J. Müller ,
Rudolf Uher ,
Sidney H. Kennedy  and
Lena C. Quilty
Timothy A. Allen*
Affiliation:
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
Raymond W. Lam
Affiliation:
Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
Roumen Milev
Affiliation:
Departments of Psychiatry and Psychology, Queen's University, Kingston, ON, Canada
Sakina J. Rizvi
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, ON, Canada Li Ka-Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
Benicio N. Frey
Affiliation:
Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada Mood Disorders Program and Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, ON, Canada
Glenda M. MacQueen
Affiliation:
Department of Psychiatry, University of Calgary, Calgary, AB, Canada
Daniel J. Müller
Affiliation:
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada
Rudolf Uher
Affiliation:
Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
Sidney H. Kennedy
Affiliation:
Department of Psychiatry, University of Toronto, Toronto, ON, Canada Li Ka-Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada
Lena C. Quilty
Affiliation:
Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada Department of Psychiatry, University of Toronto, Toronto, ON, Canada
*
Author for correspondence: Timothy A. Allen, E-mail: timothy.allen@camh.ca
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Abstract

Background

In an effort to optimize patient outcomes, considerable attention is being devoted to identifying patient characteristics associated with major depressive disorder (MDD) and its responsiveness to treatment. In the current study, we extend this work by evaluating whether early change in these sensitivities is associated with response to antidepressant treatment for MDD.

Methods

Participants included 210 patients with MDD who were treated with 8 weeks of escitalopram and 112 healthy comparison participants. Of the original 210 patients, 90 non-responders received adjunctive aripiprazole for an additional 8 weeks. Symptoms of depression and anhedonia were assessed at the beginning of treatment and 8 weeks later in both samples. Reward and punishment sensitivity were assessed using the BIS/BAS scales measured at the initiation of treatment and 2 weeks later.

Results

Individuals with MDD exhibited higher punishment sensitivity and lower reward sensitivity compared with healthy comparison participants. Change in reward sensitivity during the first 2 weeks of treatment was associated with improved depressive symptoms and anhedonia following 8 weeks of treatment with escitalopram. Similarly, improvement in reward responsiveness during the first 2 weeks of adjunctive therapy with aripiprazole was associated with fewer symptoms of depression at post-treatment.

Conclusions

Findings highlight the predictive utility of early change in reward sensitivity during antidepressant treatment for major depression. In a clinical setting, a lack of change in early reward processing may signal a need to modify a patient's treatment plan with alternative or augmented treatment approaches.

Keywords

Antidepressant treatmentdepressionmotivationpunishmentreward
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 10 , July 2019 , pp. 1629 - 1638
Copyright
Copyright © Cambridge University Press 2018 

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