ArticleDepression and anxiety2026
Identifying Clinical Predictors of Unfavorable Treatment Trajectories in Major Depressive Disorder: A National Multicentered Prospective Cohort Longitudinal, Naturalistic Study.
Article in Depression and anxiety, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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1 citing paper in PubMed.
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7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: While antidepressant side effects are often expected to diminish with continued treatment, empirical evidence remains limited. This study investigates co-trajectories of depressive severity with side-effect burden (SEB) and associated factors in patients with major depressive disorder (MDD). Methods: We analyzed longitudinal data from 1377 MDD outpatients across three Chinese multicenter studies (2015-2022), with assessments at baseline, weeks 2, 4, 8, 12, and 24. Depression severity was measured using the Quick Inventory of Depressive Symptomatology-Self Report (QIDS-SR16). At the same time, SEB was quantified using the frequency, intensity, and burden of side effects rating (FIBSER). Dual-trajectory modeling was used to identify distinct SEB and depression severity trajectories, with linear mixed-effects models comparing depression changes across SEB groups. Results: Four SEB trajectories were identified: no SEB (41.5%), early-onset SEB (29.1%), late-onset SEB (14.7%), and persistent SEB (13.9%). Depressive severity followed three trajectories: mild-responsive (66.6%), moderate-progressive (18.7%), and chronic-severe (14.7%). Persistent SEB was associated with higher baseline depression severity (OR = 1.13, 95% CI: 1.08-1.17), antidepressant combination (OR = 3.7, 95% CI: 1.52- 9.02), and poorer treatment outcomes. 7.3% exhibited concurrent chronic-severe depressive severity and persistent SEB. Female (OR = 1.95, 95% CI: 1.11-3.42), younger age (OR = 5.02, 95% CI: 2.63-9.55), higher education (high school: OR = 2.5, 95% CI: 1.12-5.36; bachelor and above: OR = 2.68, 95% CI: 1.24-5.82), and combination antidepressant (OR = 8.27, 95% CI: 2.69-25.45) were significant risk factors for concurrent severe symptoms and persistent SEB. Conclusion: Persistent antidepressant side effects coevolve with unfavorable depression trajectories over 6 months. Clinicians should prioritize early monitoring and tailored interventions for high-risk subgroups, particularly those with severe baseline symptoms or on combination therapy. These findings underscore the importance of continuous monitoring and personalized interventions to manage antidepressant side effects effectively.
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