Department of Psychiatry and Psychosomatics, Zhongda Hospital, School of Medicine, Jiangsu Provincial Key Laboratory of Brain Science and Medicine, Southeast University, Nanjing, 210009, China.
Department of Epidemiology and Biostatistics, School of Public Health, Southeast University, Nanjing, China.
J Affect Disord. 2025 Jan 15;369:559-567. doi: 10.1016/j.jad.2024.10.026. Epub 2024 Oct 9.
While millions of people suffer from major depressive disorder (MDD), research has shown that individual differences in antidepressant efficacy exist, potentially attributable to various factors. Polygenic risk scores (PRSs) carry clinical potential, but associations with treatment response are seldom reported. Here, we examined whether PRSs for MDD and schizophrenia (SCZ) are associated with antidepressant effectiveness and the influence of other factors.
A total of 999 patients were included, and the PRSs for the MDD and SCZ were calculated. The main outcome was a change in the 17-item Hamilton Depression Rating Scale (HAMD17) scores from before to after 2-week treatment. The Mann-Whitney test, Spearman correlation analysis, multiple stepwise linear regression analysis, and interaction analysis were used for statistical analysis.
In the 912 subjects passing quality control, a difference in the HAM-D17 score reduction rate between the MDD phenotype PRS (MDD-PRS) high-risk and the low-risk groups was discovered (P = 0.009), and a correlation was found between the MDD-PRS and the HAM-D17 score reduction rate (r = -0.075, P = 0.024). Moreover, antidepressant efficacy was related to MDD-PRS (β = -4.086, P = 0.039), the Snaith-Hamilton Pleasure Scale-total score (β = -0.009, P = 0.005), and non-first episode (β = -0.039, P < 0.001). However, the result of the interaction analysis was nonsignificant.
The main limitation was that only 1309 targeted genes were selected based on pathways known to be involved in MDD and/or antidepressant effects.
These findings suggest a difference in antidepressant efficacy between patients in different MDD-PRS groups. Moreover, the MDD-PRS combined with clinical characteristics partially explained inter-individual differences in antidepressant efficacy.
尽管数百万人患有重度抑郁症(MDD),但研究表明,抗抑郁药疗效存在个体差异,这可能归因于各种因素。多基因风险评分(PRS)具有临床潜力,但很少有报道与治疗反应相关。在这里,我们研究了 MDD 和精神分裂症(SCZ)的 PRS 是否与抗抑郁药的有效性以及其他因素的影响有关。
共纳入 999 例患者,计算 MDD 和 SCZ 的 PRS。主要结局是从治疗前到治疗后 2 周 17 项汉密尔顿抑郁评定量表(HAMD17)评分的变化。采用 Mann-Whitney 检验、Spearman 相关分析、多元逐步线性回归分析和交互分析进行统计学分析。
在通过质量控制的 912 例患者中,发现 MDD 表型 PRS(MDD-PRS)高风险和低风险组之间 HAM-D17 评分降低率存在差异(P=0.009),且 MDD-PRS 与 HAM-D17 评分降低率呈负相关(r=-0.075,P=0.024)。此外,抗抑郁药疗效与 MDD-PRS(β=-4.086,P=0.039)、Snaith-Hamilton 快感量表总分(β=-0.009,P=0.005)和非首发(β=-0.039,P<0.001)有关。然而,交互分析的结果无统计学意义。
主要限制在于仅根据已知与 MDD 和/或抗抑郁作用相关的途径选择了 1309 个靶向基因。
这些发现表明,不同 MDD-PRS 组的患者抗抑郁药疗效存在差异。此外,MDD-PRS 结合临床特征部分解释了抗抑郁药疗效的个体间差异。