Subtype of depression as a moderator of response in the treatment of major depression with St John's wort

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Objective: To evaluate the effect of the melancholic and anxious subtypes of depression on treatment response in the Hypericum Depression Trial. Methods: 340 adults with depression were classified according to depression subtype at baseline. Linear and logistic regression models examined the effects of depression subtype and treatment assignment on treatment response. Results: 64.41% of participants had melancholic depression and 71.76% had anxious depression. The linear regression model demonstrated that melancholic depression status at baseline and the interaction of treatment assignment and baseline melancholic status had significant effects on depression severity. The linear regression model showed significant effects only for treatment and anxious depression status at baseline on depression severity. Conclusion: While depression subtype appears to be related to certain clinical characteristics, this study was inconclusive and did not find melancholic or anxious depression subtypes to significantly moderate response to treatment with St John's wort, placebo, or sertraline.