Depression and suicidality severity among TRD patients after 1-year under standard of care: Findings from the TRAL study, a multicenter, multinational, observational study in Latin America

Introduction: Treatment resistant depression (TRD) is one of the most pressing issues in mental healthcare in LatAm. However, clinical data and outcomes of standard of care (SOC) are scarce. The present study reported on the Treatment-Resistant Depression in America Latina (TRAL) project 1-year follow-up of patients under SOC assessing clinical presentation and outcomes. Materials and methods: 420 patients with clinical diagnoses of TRD from Argentina, Brazil, Colombia and Mexico were included in a 1-year follow-up to assess clinical outcomes of depression (MADRS) and suicidality (C-SSRS), as well as evolution of clinical symptoms of depression. Patients were assessed every 3 months and longitudinal comparison was performed based on change from baseline to each visit and end of study (12 months). Socio demographic characterization was also performed. Results: Most patients were female (80.9%), married (42.5%) or single (34.4%), with at least 10 years of formal education (71%). MDD diagnosis was set at 37.29 (SD = 14.00) years, and MDD duration was 11.11 years (SD = 10.34). After 1-year of SOC, 79.1% of the patients were still symptomatic, and 40% of the patients displayed moderate/severe depression. Only 44.1% of the patients achieved a response (>= 50% improvement in MADRS), and 60% of the sample failed to achieve remission. Suicidal ideation was reported by more than half of the patients at the end of study. Conclusions: Depression and suicidality symptoms after a 1-year of SOC is of great concern. Better thera-peutic options are needed to tackle this debilitating and burdensome disease. (c) 2022 The Author(s). Published by Elsevier Espana, S.L.U. on behalf of Sociedad Espanola de Psiquiatria y Salud Mental (SEPSM). All rights reserved. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by-nc-sa/4.0/).