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This page is an AI-assisted Turkish summary of the study presented at the 26th World Congress of Psychiatry. The study belongs to the presenting authors; please refer to the original source when citing it.

SO093

Treatment switching patterns and proxy indicators of treatment resistance in depressive disorders: An eight-year cohort study from the United Arab Emirates

TREATMENT MODIFICATION PATTERNS AND PROXIES OF TREATMENT RESISTANCE IN DEPRESSIVE DISORDERS: AN EIGHT-YEAR COHORT STUDY FROM THE UNITED ARAB EMIRATES

In the cohort shown in the poster, one-year antidepressant treatment persistence was 63.1%, and the strongest modifiable predictor of discontinuation was the care setting in which treatment was initiated, rather than antidepressant class.

Note: although the title and conference abstract of this record concern treatment switching patterns, the poster image presents a different analysis by the same team (Treatment persistence and discontinuation patterns in depressive disorders: A real-world cohort study from the United Arab Emirates); the summary below is based on the poster content. The aim was to describe treatment persistence and its predictors among adults newly initiating antidepressants for major depressive disorder in the UAE, compare SSRIs with SNRIs using propensity score matching, and examine the transition to outpatient care following treatment initiation in the emergency department. This was a retrospective cohort study conducted within a single tertiary psychiatric care network; 2,025 adults diagnosed with ICD-10 F32/F33 were followed using ISPOR-aligned days-supply criteria and a permissible 60-day prescription refill gap. Kaplan–Meier estimation and a multivariable Cox proportional hazards model (N=2,024) were used, and 1:1 propensity score matching was performed for SSRIs versus SNRIs (272 matched pairs). One-year persistence was 63.1% (Kaplan–Meier), and the median time to discontinuation was 649 days, with one in three patients discontinuing treatment within the first year; persistence was 92.2% at day 30, 86.5% at day 90, 76.4% at day 180, and 63.1% at day 365. By care setting, one-year persistence was 67.9% among those initiating treatment in outpatient care, 66.6% in inpatient care, 53.4% in the emergency department, and 44.8% via telemedicine. In the Cox model, factors associated with an increased risk of discontinuation were psychiatric comorbidity (HR 1.76; 95% CI 1.40 to 2.21; p<0.001), medical comorbidity (HR 1.66; 1.36 to 2.02; p<0.001), initiation via telemedicine (HR 1.82; 1.34 to 2.46; p<0.001), initiation in the emergency department (HR 1.66; 1.33 to 2.08; p<0.001), and Emirati citizenship (HR 1.32; 1.11 to 1.57; p=0.001), whereas each additional year of age was protective (HR 0.99; 0.98 to 1.00; p=0.002), and initiation in inpatient care was not statistically significant (HR 0.79; 0.61 to 1.02; p=0.075). No difference was detected between antidepressant classes (one-year persistence: SSRIs 62.3%, SNRIs 65.7%, tricyclics 64.1%, others 63.3%; log-rank p=0.66; matched SSRI versus SNRI comparison p=0.83); of the 575 patients who initiated treatment in the emergency department, 301 (52.3%) received an outpatient or telemedicine prescription within a median of 10 days, while the remaining 274 (47.7%) had no documented transition to outpatient care during follow-up. In conclusion, although one-year persistence was at the upper end of the international range, the care setting in which treatment was initiated, rather than drug class or demographic characteristics, was the strongest modifiable correlate of discontinuation, and approximately half of patients who initiated treatment in the emergency department never transitioned to ongoing outpatient care.

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