{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T00:35:21Z","timestamp":1775608521294,"version":"3.50.1"},"reference-count":47,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2017,12,13]],"date-time":"2017-12-13T00:00:00Z","timestamp":1513123200000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100003579","name":"University of Toronto","doi-asserted-by":"publisher","award":["R01 MH083643"],"award-info":[{"award-number":["R01 MH083643"]}],"id":[{"id":"10.13039\/501100003579","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007408","name":"University of Pittsburgh Medical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007408","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1 TR000448"],"award-info":[{"award-number":["UL1 TR000448"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J American Geriatrics Society"],"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/Objectives<\/jats:title>\n                    <jats:p>Metabolic syndrome (MetS) is the co\u2010occurrence of obesity and metabolic derangements. Prior research implicates MetS in prolongation of the course of depression in older adults, but its effect on antidepressant response is unknown in this population. The objective was to determine whether MetS and related metabolic dyscrasias are associated with decreased rate of remission from depression in older adults treated pharmacologically for depression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Secondary analysis of a randomized controlled trial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Three academic medical centers in North America.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      Adults aged 60 and older (mean age 69.1) with major depressive disorder (\n                      <jats:styled-content style=\"fixed-case\">MDD<\/jats:styled-content>\n                      ) (N\u00a0=\u00a0435).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Intervention<\/jats:title>\n                    <jats:p>Open\u2010label, protocolized treatment with extended\u2010release venlafaxine for 12 or more weeks.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements<\/jats:title>\n                    <jats:p>\n                      Time to remission from depression, with remission defined as a Montgomery\u2010\u00c5sberg Depression Rating Scale (\n                      <jats:styled-content style=\"fixed-case\">MADRS<\/jats:styled-content>\n                      ) score of 10 or less at last two visits.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two hundred twenty\u2010two participants (51%) met criteria for MetS at baseline; MetS was associated with greater severity (\n                      <jats:styled-content style=\"fixed-case\">MADRS<\/jats:styled-content>\n                      score) and chronicity of depression at baseline. Remission was achieved in 182 participants (42%). In the unadjusted analysis, MetS was associated with prolonged time to remission (hazard ratio for remission\u00a0=\u00a00.71, 95% confidence interval\u00a0=\u00a00.52\u20130.95), but this relationship was not significant in the adjusted model; greater number of MetS components and lower high\u2010density lipoprotein cholesterol had similar effects. Only diastolic blood pressure (\n                      <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n                      ) was a significant predictor of time to remission before and after adjustment, with higher\n                      <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n                      predicting longer time to remission. Insulin sensitivity did not predict time to remission.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The presence of MetS in older adults with depression was associated with greater symptom severity and chronicity of depression, which appears to have accounted for the poorer antidepressant response observed in those with MetS. Additionally, our preliminary finding of an association between higher\n                      <jats:styled-content style=\"fixed-case\">DBP<\/jats:styled-content>\n                      and poorer antidepressant response bears further examination and replication.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jgs.15129","type":"journal-article","created":{"date-parts":[[2017,12,13]],"date-time":"2017-12-13T05:45:55Z","timestamp":1513143955000},"page":"2651-2658","source":"Crossref","is-referenced-by-count":32,"title":["Effect of Metabolic Syndrome on Late\u2010Life Depression: Associations with Disease Severity and Treatment Resistance"],"prefix":"10.1111","volume":"65","author":[{"given":"John S.","family":"Mulvahill","sequence":"first","affiliation":[{"name":"Healthy Mind Lab Department of Psychiatry School of Medicine Washington University St. Louis Missouri"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ginger 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