A new analysis of results from the genomics used to improve depression decisions (Guided) clinical trial reveals that the 6-item Hamilton depression rating scale (Ham-D6) identified statistically significant improvements in all three clinical endpoints—remission, response, and symptoms—between care guided by GeneSight, from Myriad Genetics, Salt Lake City, and treatment as usual at week 8.
“The Ham-D6 scale has been shown to be a better measure of core depressive symptoms than the Ham-D17 scale,” says Boadie W. Dunlop, MD, an associate professor of psychiatry and behavioral sciences at the Emory University School of Medicine and one of the study investigators. “This post-hoc analysis provides further evidence that the GeneSight test led to significant and clinically meaningful improvements in clinical outcomes for patients with major depressive disorder relative to treatment-as-usual care.”
The Guided study is the largest prospective study to assess the benefit of pharmacogenomics-guided treatment for depression using the GeneSight psychotropic test versus an active therapy control arm. As part of the study protocol, all patients in the Guided study completed the 17-item Ham-D17 questionnaire, which was administered by blinded off-site raters.
The 6-item Ham-D6 score represents a subset of Ham-D17 questions that have been shown to be more directly linked to depression. For example, questions such as ‘Have you had trouble sleeping?’ which could be associated with conditions other than depression, are excluded from the Ham-D6 score. Clinical studies have shown that the Ham-D6 score is superior to Ham-D17 at discriminating antidepressants from placebo.
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- Dunlop BW, Parikh SV, Rothschild AJ, et al. Comparing sensitivity to change using the 6-item versus the 17-item Hamilton depression rating scale in the Guided randomized controlled trial. BMC Psychiatry. 2019;19(1):420; doi: 10.1186/s12888-019-2410-2.
In the Guided study, the GeneSight test from Myriad Genetics significantly improved clinical outcomes for patients suffering from major depressive disorder.