Anhedonia predicts poorer recovery among youth with selective serotonin reuptake inhibitor treatmentresistant depression

Dana L. McMakin, Thomas M. Olino, Giovanna Porta, Laura J. Dietz, Graham Emslie, Gregory Clarke, Karen Dineen Wagner, Joan R. Asarnow, Neal D. Ryan, Boris Birmaher, Wael Shamseddeen, Taryn Mayes, Betsy Kennard, Anthony Spirito, Martin Keller, Frances L. Lynch, John F. Dickerson, David A. Brent

Research output: Contribution to journalArticlepeer-review

183 Scopus citations


Objective: To identify symptom dimensions of depression that predict recovery among selective serotonin reuptake inhibitor (SSRI) treatmentresistant adolescents undergoing second-step treatment. Method: The Treatment of Resistant Depression in Adolescents (TORDIA) trial included 334 SSRI treatmentresistant youth randomized to a medication switch, or a medication switch plus CBT. This study examined five established symptom dimensions (Child Depression Rating ScaleRevised) at baseline as they predicted recovery over 24 weeks of acute and continuation treatment. The two indices of recovery that were evaluated were time to remission and number of depression-free days. Results: Multivariate analyses examining all five depression symptom dimensions simultaneously indicated that anhedonia was the only dimension to predict a longer time to remission, and also the only dimension to predict fewer depression-free days. In addition, when anhedonia and CDRS-total score were evaluated simultaneously, anhedonia continued to uniquely predict longer time to remission and fewer depression-free days. Conclusions: Anhedonia may represent an important negative prognostic indicator among treatment-resistant depressed adolescents. Further research is needed to elucidate neurobehavioral underpinnings of anhedonia, and to test treatments that target anhedonia in the context of overall treatment of depression. Clinical trial registration informationTreatment of SSRI-Resistant Depression in Adolescents (TORDIA);; NCT00018902.

Original languageEnglish (US)
Pages (from-to)404-411
Number of pages8
JournalJournal of the American Academy of Child and Adolescent Psychiatry
Issue number4
StatePublished - Apr 2012


  • adolescence
  • clinical trial
  • cognitive-behavioral therapy
  • depression
  • treatment-resistant

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Psychiatry and Mental health


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