***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE The authors examined  gender differences in  response to tricyclic antidepressants . METHOD A total of 30 r and omized , placebo-controlled trials that included 3,886 patients ( 1,555 men and 2,331 women ) , su bmi tted between 1979 and 1991 in order to obtain marketing authorization , were review ed .  Gender differences in response to treatment were tested in various multiple regression models using a variety of response definitions . RESULTS Different response definitions all pointed to no gender difference in the efficacy of tricyclic antidepressants .  The estimated effect size was similar for women younger and older than age 50 and for men . CONCLUSIONS  Tricyclic antidepressant response is independent of gender Major depression and anxiety frequently co-occur , but the implication s for psychological treatments have rarely been studied . We examined predictors of acute response to interpersonal psychotherapy in 134 consecutively treated female out patients with recurrent unipolar depression . Women who failed to remit with interpersonal psychotherapy alone experienced higher levels of somatic anxiety , were more likely to meet criteria for lifetime panic disorder , were more likely to meet criteria for nonendogenous or nonmelancholic depression , and reported greater vocational impairment , higher levels of global severity , a longer duration of the index episode , and , somewhat surprisingly , lower levels of social impairment at pretreatment evaluation . A series of backwards stepping logistic regression analyses showed higher levels of baseline somatic anxiety and social functioning to be the most consistent predictors of nonresponse . Our findings strengthen existing evidence that concomitant anxiety can adversely affect the outcome of  interpersonal therapy  for depression This article describes a post-hoc analysis of clinical and psychosocial factors and beliefs about health associated with treatment outcome in a sample of depressed primary care patients ( N=181 ) r and omly assigned to a st and ardized treatment or physician 's usual care ( UC ) . Different factors were found to predict clinical outcomes for treatment modality [ UC vs. interpersonal psychotherapy ( IPT ) or nortriptyline ( NT ) ] and the type of outcome evaluated ( i.e. , depressive symptoms at 8 months or symptomatic and functional recovery at 8 months ) . Factors associated with treatment-specific outcomes are also described . Consistent with prior studies , lower depressive symptom severity at 8 months was associated with higher baseline functioning , minimal medical co-morbidity , race , and st and ardized pharmacologic or psychotherapeutic treatment . Additionally , an interaction between treatment modality and health locus of control indicated that individuals perceiving more self-control of their health and who received a st and ardized treatment experienced greater depressive symptom reduction at 8 months . Factors associated with symptomatic and functional recovery from the depressive episode were also examined . Patients who received a st and ardized treatment ( IPT or NT ) perceived greater control of their health and lacked a lifetime generalized anxiety disorder or panic disorder were more likely to recover by month 8 than those who received usual care . While clinical severity and treatment adequacy play an important role in both symptomatic improvement and full recovery from a depressive episode , other key factors such as health beliefs and non-depressive psychopathology also influence recovery BACKGROUND Patients with chronic forms of major depression are difficult to treat , and the relative efficacy of medications and psychotherapy is uncertain . METHODS We r and omly assigned 681 adults with a chronic nonpsychotic major depressive disorder to 12 weeks of outpatient treatment with  nefazodone ( maximal dose , 600 mg per day ) , the cognitive behavioral- analysis system of psychotherapy ( 16 to 20 sessions ) , or both . At base line , all patients had scores of at least 20 on the 24-item Hamilton Rating Scale for Depression ( indicating clinical ly significant depression ) . Remission was defined as a score of 8 or less at weeks 10 and 12 . For patients who did not have remission , a satisfactory response was defined as a reduction in the score by at least 50 percent from base line and a score of 15 or less . Raters were unaware of the patients ' treatment assignments . RESULTS Of the 681 patients , 662 attended at least one treatment session and were included in the analysis of response . The overall rate of response ( both remission and satisfactory response ) was 48 percent in both the nefazodone group and in the psychotherapy group , as compared with 73 percent in the combined-treatment group . ( P<0.001 for both comparisons ) . Among the 519 subjects who completed the study , the rates of response were 55 percent in the nefazodone group and 52 percent in the psychotherapy group , as compared with 85 percent in the combined-treatment group ( P<0.001 for both comparisons ) . The rates of withdrawal were similar in the three groups . Adverse events in the nefazodone group were consistent with the known side effects of the drug ( e.g. , headache , somnolence , dry mouth , nausea , and dizziness ) . CONCLUSIONS Although about half of patients with chronic forms of major depression have a response to short-term treatment with either nefazodone or a cognitive behavioral- analysis system of psychotherapy , the combination of the two is significantly more efficacious than either treatment alone OBJECTIVE Selective serotonin reuptake inhibitors ( SSRIs ) are widely used to treat depression , but the rates , timing , and baseline predictors of remission in " real world " patients are not established . The authors ' primary objectives in this study were to evaluate the effectiveness of citalopram , an SSRI , using measurement-based care in actual practice , and to identify predictors of symptom remission in out patients with major depressive disorder . METHOD This clinical study included out patients with major depressive disorder who were treated in 23 psychiatric and 18 primary care " real world " setting s. The patients received flexible doses of citalopram prescribed by clinicians for up to 14 weeks . The clinicians were assisted by a clinical research coordinator in the application of measurement-based care , which included the routine measurement of symptoms and side effects at each treatment visit and the use of a treatment manual that described when and how to modify medication doses based on these measures . Remission was defined as an exit score of < or=7 on the 17-item Hamilton Depression Rating Scale ( HAM-D ) ( primary outcome ) or a score of < or=5 on the 16-item Quick Inventory of Depressive Symptomatology , Self-Report ( QIDS-SR ) ( secondary outcome ) . Response was defined as a reduction of > or=50 % in baseline QIDS-SR score . RESULTS Nearly 80 % of the 2,876 out patients in the analyzed sample had chronic or recurrent major depression ; most also had a number of comorbid general medical and psychiatric conditions . The mean exit citalopram dose was 41.8 mg/day . Remission rates were 28 % ( HAM-D ) and 33 % ( QIDS-SR ) . The response rate was 47 % ( QIDS-SR ) . Patients in primary and psychiatric care setting s did not differ in remission or response rates . A substantial portion of participants who achieved either response or remission at study exit did so at or after 8 weeks of treatment . Participants who were Caucasian , female , employed , or had higher levels of education or income had higher HAM-D remission rates ; longer index episodes , more concurrent psychiatric disorders ( especially anxiety disorders or drug abuse ) , more general medical disorders , and lower baseline function and quality of life were associated with lower HAM-D remission rates . CONCLUSIONS The response and remission rates in this highly generalizable sample with substantial axis I and axis III comorbidity closely resemble those seen in 8-week efficacy trials . The systematic use of easily implemented measurement-based care procedures may have assisted in achieving these results OBJECTIVE The authors examined gender differences in treatment response to sertraline , a selective serotonin reuptake inhibitor ( SSRI ) , and to imipramine , a tricyclic antidepressant , in chronic depression . METHOD A total of 235 male and 400 female out patients with DSM-III-R chronic major depression or double depression ( i.e. , major depression superimposed on dysthymia ) were r and omly assigned to 12 weeks of double-blind treatment with sertraline or with imipramine after placebo washout . RESULTS Women were significantly more likely to show a favorable response to sertraline than to imipramine , and men were significantly more likely to show a favorable response to imipramine than to sertraline . Gender and type of medication were also significantly related to dropout rates ; women who were taking imipramine and men who were taking sertraline were more likely to withdraw from the study . Gender differences in time to response were seen with imipramine , with women responding significantly more slowly than men . Comparison of treatment response rates by menopausal status showed that premenopausal women responded significantly better to sertraline than to imipramine and that postmenopausal women had similar rates of response to the two medications . CONCLUSIONS Men and women with chronic depression show differential responsivity to and tolerability of SSRIs and tricyclic antidepressants .  The differing response rates between the drug classes in women was observed primarily in premenopausal women . Thus , female sex hormones may enhance response to SSRIs or inhibit response to tricyclics . Both gender and menopausal status should be considered when choosing an appropriate antidepressant for a depressed patient Predictive variables of response to imipramine and to phenelzine at 6 weeks and 6 months were studied in 116 patients suffering from major depression with melancholia ( DSM-III ) . Several sociodemographic , clinical , and biological variables were studied . For imipramine-treated patients , high social support predicted a better response at 6 weeks , while development of hypomania during follow-up was associated with a better response at 6 weeks ; absence of life events during the 6-month follow-up and initial non-suppression of dexamethasone predicted a better outcome at 6 months . For phenelzine-treated patients , development of hypomania during follow-up was associated with a better outcome at 6 months and absence of life events prior to the onset of the episode was associated with a worse outcome at 6 months OBJECTIVE The first objective of this paper was to describe the pattern of remission , response and recovery in patients with major depression who were r and omised for treatment with fluoxetine ornortriptyline .  The second objective was to report on the demographic and diagnostic predictors of the response and recovery in these depressed patients . METHOD One hundred and ninety-five patients with major depression were recruited for this outpatient study . After a detailed clinical and neurobiological evaluation patients were r and omized to receive either fluoxetine or nortiptyline as an initial antidepressant treatment . RESULTS Of the 195 depressed patients r and omised to treatment,154 completed an adequate 6-week trial of either fluoxetine or nortriptyline as their initial antidepressant . Of the 41 patients who did not complete an adequate trial the dropout rate was higher on those r and omized to nortriptyline ( p = 0.02 ) . There was also an important interaction of drug and gender in determining dropouts in that women did not complete an adequate trial with nortriptyline and men did not complete an adequate trial with fluoxetine ( p = 0.002 ) . Of the 154 patients who completed an adequate 6-week antidepressant trial there were no significant differences in 6-week measures of depression severity or of percentage improvement . However , if we use an intention to treat analysis and dichotomise outcomes into response , remission or recovery ; then recovery rates were significantly higher with fluoxetine than nortriptyline ( p = 0.005 ) . Using an intention to treat analysis fluoxetine was superior tonortriptyline in women , in those less than 25-years old , and in those with atypical depression . Independent of drug , those with chronic depressions had a poorer outcome . CONCLUSION In this sample of depressed patients r and omized tonortriptyline or fluoxetine the change in depressive symptoms over 6 weeks were comparable between fluoxetine and nortriptyline . However , when we look at the more clinical ly important variable of recovery then fluoxetine was superior to nortriptyline . Predictors of a poorer response to nortriptyline were gender , young age and atypical depression . The results challenge traditional beliefs that selective serotonin re-uptake inhibitors ( SSRIs ) and tricyclic antidepressant have comparable efficacy BACKGROUND It is well established that subjects participating in controlled clinical trials may not be representative of patients seen in actual practice . Given that efficacy and safety of sertraline have been investigated almost exclusively in controlled clinical trials , the aim of this study was to investigate efficacy , safety , and predictors of treatment response to sertraline in routine clinical practice . METHODS A total of 1878 depressed out patients ( 69.5 % female ; mean age , 50.3 years ) participated in this prospect i ve , open-label , non-interventional , postmarketing surveillance study of sertraline . The primary study outcome was change in depression severity as assessed independently with the Patient Health Question naire ( PHQ-9 ) depression scale and Clinical Global Impression ( CGI ) scales after 12 weeks of treatment . Stepwise logistic regression analyses were used to identify independent predictors of treatment response . RESULTS Using st and ard criteria to define clinical improvement , responder rates were 87.7 % ( PHQ-9 ) and 87.2 % ( CGI ) , respectively . Remission , i.e. a PHQ-9 score of 5 or below , occurred in 56.9 
    Output:
    
There were no findings indicating that gender was associated with treatment outcome in the case of tricyclic antidepressants .
There are some indications that younger patients respond worse to tricyclics , whereas especially women appeared to have better outcomes with modern antidepressants ( selective serotonin/norepinephrine reuptake inhibitors ) .
Marital status may be related to better outcome in the case of antidepressants and cognitive-behavioral therapy .
Longer duration of depression was identified as a negative predictor , most consistently in psychotherapy .
In none of the treatment modalities was recurrence a negative predictor .