Sociodemographic features predict antidepressant trajectories of response in diverse antidepressant pharmacotreatment environments: a comparison between the STAR*D study and an independent trial

There is consistent evidence that sociodemographic variables modulate antidepressant response. How the magnitude of such association behaves in different samples and different environments has been poorly investigated. We validated a set of known sociodemographic predictors for trajectories of antidepressant response in both the sequenced treatment alternatives to relieve depression and in an Italian sample. The odds ratios for response were 2.6 and 2.2 (American and Italian, respectively; P = 0.0005 and P = 0.002) for a combination of sociodemographic variables in both groups. This was surprising in that American patients were treated in a variety of specialized or not specialized units widespread in their country, whereas the Italian patients were all inpatients treated in a structure specialized in mood disorders. Thus, we suggest that the environment in which a depressed patient is treated does not significantly affect the association between sociodemographic predictors and response to the pharmacological antidepressant treatment.