The purpose of this study is to describe the epidemiology of Treatment Resistant Depression (TRD) in the US, including the population incidence of TRD, and TRD as a proportion of Pharmacologically Treated Depression (PTD), and stratify the estimates by sex and age group, with separate estimates for the Medicaid population, the Medicare population, and the privately insured population. Anonymized participants data will be used for the analysis.
Study Type
OBSERVATIONAL
Enrollment
200,000
Incidence Rate of Treatment Resistant Depression
TRD will be defined as the failure of two medications, as marked by their replacement or supplementation with other medications using three alternative definitions. In one the time for a medication regimen to fail is limited to less than or equal to (\<=) 3 months and in the second the time for a medication regimen to fail is limited to \<= 6 months, both corresponding to the medication never providing adequate relief. In the third, the time for a medication regimen to fail will be limited to \<= 2 years, corresponding to the medication not providing permanent or very long lasting relief.
Time frame: Up to 4 years
Treatment Resistant Depression as a Proportion of Pharmacologically Treated Depression
An episode of PTD begins when a member of the study cohort receives a dispensing of an antidepressant (AD) medication and receives a diagnosis of depression between 180 days before that dispensing and 30 days after that dispensing.
Time frame: Up to 4 years
Incidence Rate of Treatment Resistant Depression by Age Group and Sex
TRD incidence will be stratified by age group and sex under each of the three definitions of failure of a medication regimen.
Time frame: Up to 4 years
Incidence Rate of TRD as Separate Estimates for the Medicaid Population, the Medicare Population, and the Privately Insured Population
TRD incidence will be stratified by data population (database): Medicaid, Medicare, Privately insured.
Time frame: Up to 4 years
Incidence on TRD Based on Sensitivity Analysis
Sensitivity analyses are intended to clarify how the results of the present study will compare to the results of other studies that may define as The maximum time for failure of a regimen is changed to: 60, 120, 150, or 365 days, or is not limited; the requirement that a regimen include greater than or equal to (\>=) 28 days' supply of the antidepressant medication and antipsychotic medication (if present) is changed to \>= 42 days and 14 days supply; participants who get an excluded diagnosis are retroactively excluded from the study cohort; or the definition of an incident case adds a requirement for no depression diagnosis in the prior year.
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Time frame: Up to 4 years
Number of Participants With Selected Markers for Severity of Depression
The following markers of severity will be tabulated during the PTD episodes and stratified according to whether the participant develops or does not develop TRD during the study period: Electro-convulsive therapy, hospitalization with a diagnosis of depression, receiving a diagnosis of suicidal thoughts, receiving a diagnosis of self-harm, emergency department visit with a diagnosis of injury, emergency department visit with a diagnosis of poisoning.
Time frame: Up to 4 years