Predicting Responses to Treatment for Depression

Predicting the optimal personalized treatment for major depression remains elusive. In two related studies, investigators aimed to identify a neuroimaging biomarker predicting treatment response in adults with a first nonpsychotic major depressive episode who had been randomized to 12 weeks of cognitive-behavioral therapy (CBT), escitalopram, or duloxetine.

Based on suggestions linking the subcallosal cingulate cortex (SCC) to depression pathophysiology, researchers studied SCC connectivity patterns on functional magnetic resonance imaging (fMRI) in 122 completers (medication, 85; CBT, 37) with adequate fMRIs who had clear remission (Hamilton Rating Scale for Depression [HRSD] score, ≤7) or treatment failure (<30% reduction from baseline HRS…