Therapy response and therapy response prediction

Group Leader

Co-Leader

Group members

• PD Dr. Nadine Dreimüller
• Dr. Friedrich Duge
• Dr. David Herzog
• Kathrin Kachel
• Jutta Stoffers-Winterling
• PD Dr. Stefanie Wagner

The aim of our research is to improve and accelerate the treatment of depressive patients. We try to identify, replicate and transfer clinical, biochemical, immunological, genetic, neuropsychological and neurofunctional predictors for good and bad therapy response in the early course of the disease. For this purpose, cohorts of depressive patients as well as translational approaches in animal models are investigated. If the response rates to current antidepressants remain inadequate, the identification of valid predictors that can predict therapy response at an early stage is of enormous clinical relevance.

The group also performs systematic reviews and metaanalyses using the methods of the Cochrane Collaboration with a focus on affective disorders and Borderline Personality Disorder and holds a world leading position especially in the area of evidence syntheses in Personality Disorders (see also research group Lieb at the Leibniz Institute for Resilience Research).

Current projects:

Individual Determinants of Antidepressant Response- a longitudinal study (IDeA-L) - Longitudinal study of depressive disease progression to improve therapy response prediction through detailed phenotyping 

The aim of the study is an intensive collection of clinical, sociodemographic and neuropsychological parameters as well as biological markers (genetic, epigenetic, proteomic, microbiome-based, immunological, electrophysiological and imaging analyses). Through this detailed phenotyping during the acute phase of the disease as well as over the two-year long-term course, predictors for successful antidepressive treatment are identified that may improve the prediction of therapy response.

The Early Medication Change (EMC) Study

The EMC study was a BMBF-funded randomized controlled trial enrolling 889 patients with major depressive disorders to compare an early medication change strategy to treatment as usual in patients with an early non-improvement to 2 weeks of escitalopram treatment. Currently, various studies are performed to investigate biological and neuropsychological markers with the help of machine learning procedures for therapy response prediction.

PsychAssist

With the Fraunhofer Institute for Industrial Mathematics, Kaiserslautern, our group is developing knowledge-based decision support systems for personalised diagnostics and treatment planning. PsychAssist uses artificial intelligence methods to describe and predict treatment courses and to develop tools for therapy guidance of individual patients through an integration of recommendations from guidelines, meta-analyes, and the individual course of the disease in a single patient.

Systematic reviews and metaanalyses in Borderline Personality Disorder

Since 2009, our group performs systematic reviews and metaanalyses with a special focus on psychological and pharmacological treatment options in Borderline Personality Disorder. 

  

Cooperations

• Prof. Dr. Dieter Braus, Wiesbaden
• Prof. Dr. Helge Frieling, Hannover
• Prof. Dr. Dr. Martin Härter, Hamburg
• Prof. Dr. Wolfgang Kelsch, Mainz
• Dr. Geraldine Macdonald, Bristol, UK
• Prof. Dr. Marianne Müller, Mainz
• PD Dr. Murck, New York/Marburg
• Prof. Dr. Matthias Riemenschneider
• Prof. Dr. Marcella Rietschel, Mannheim
• Prof. Dr. Martin Schäfer, Essen
• Dr. Alexander Scherrer, Fraunhofer Institute for Industrial Mathematics, Kaiserslautern
• Prof. Dr. Erik Simonsen, Copenhagen, Denmark
• Prof. Dr. Jakob Ole Storebo, University of Southern Denmark, Denmark
• Prof. Dr. Andre Tadic, Liebenburg

Funding

• German Research Foundation (DFG)
• Federal Ministry of Education and Research (BMBF)

Key publications

• Wagner S, Wollschläger D, Dreimüller N, Engelmann J, Herzog DP, Roll SC, Tadić A, Lieb K (2020). Effects of age on depressive symptomatology and response to antidepressant treatment in patients with major depressive disorder aged 18 to 65 years. Compr Psychiatry 99:152170.
• Stoffers-Winterling J, Storebø OJ, Lieb K. Pharmacotherapy for Borderline Personality Disorder: an Update of Published, Unpublished and Ongoing Studies. Curr Psychiatry Rep. 2020 Jun 5;22(8):37. doi: 10.1007/s11920-020-01164-1
• Storebø OJ, Stoffers-Winterling JM, Völlm BA, Kongerslev MT, Mattivi JT, Jørgensen MS, Faltinsen E, Todorovac A, Sales CP, Callesen HE, Lieb K, Simonsen E. Psychological therapies for people with borderline personality disorder. Cochrane Database Syst Rev. 2020 May 4;5(5):CD012955
• Wagner S, Kayser S, Engelmann J, Schlicht KF, Dreimüller N, Tüscher O, Müller-Dahlhaus F, Braus DF, Tadić A, Neyazi A, Frieling H, Lieb K (2019). Plasma brain-derived neurotrophic factor (pBDNF) and executive dysfunctions in patients with major depressive disorder. World J Biol Psychiatry 20: 519-530.
• Dreimüller N, Lieb K, Tadic A, Engelmann J, Wollschläger D, Wagner S (2019). Body mass index (BMI) in major depressive disorder and its effects on depressive symptomatology and antidepressant response. J Affect Disord 256: 524-531.
• Lieb K, Dreimüller N, Wagner S, Schlicht K, Falter T, Neyazi A, Müller-Engling L, Bleich S, Tadić A, Frieling H (2018). BDNF plasma levels and BDNF exon IV promoter methylation as predictors for antidepressant treatment response. Front Psychiatry. 9: 511.
• Wagner S, Helmreich I, Wollschläger D, Meyer K, Kaaden S, Reiff J, Roll SC, Braus D, Tüscher O, Müller-Dahlhaus F, Tadić A, Lieb K (2018). Early improvement of executive test performance during antidepressant treatment predicts treatment outcome in patients with Major Depressive Disorder. PLoS One13(4): e0194574.
• Wagner S, Engel A, Engelmann J, Herzog D, Dreimüller N, Müller MB, Tadić A, Lieb K (2017). Early improvement as a resilience signal predicting later remission to antidepressant treatment in patients with Major Depressive Disorder: Systematic review and meta-analysis. J Psychiatr Res 94: 96-106.
• Wagner S, Tadić A, Roll SC, Engel A, Dreimüller N, Engelmann J, Lieb K (2017). A combined marker of early non-improvement and the occurrence of melancholic features improve the treatment prediction in patients with Major Depressive Disorders. J Affect Disord 221: 184-191.
• Herzog DP, Wagner S, Ruckes C, Tadic A, Roll SC, Härter M, Lieb K (2017). Guideline adherence of antidepressant treatment in outpatients with major depressive disorder: a naturalistic study. Eur Arch Psychiatry Clin Neurosci 267: 711-721.
• Nicod J, Wagner S, Vonberg F, Bhomra A, Schlicht KF, Tadic A, Mott R, Lieb K, Flint J (2016) .The Amount of Mitochondrial DNA in Blood Reflects the Course of a Depressive Episode. Biol Psychiatry 80: e41-e42.
• Tadić A, Wachtlin D, Berger M, Braus DF, van Calker D, Dahmen N, Dreimüller N, Engel A, Gorbulev S, Helmreich I, Kaiser AK, Kronfeld K, Schlicht KF, Tüscher O, Wagner S, Hiemke C, Lieb K (2016). Randomized controlled study of early medication change for non-improvers to antidepressant therapy in major depression--The EMC trial. Eur Neuropsychopharmacol 26: 705-516.
• Tadić A, Müller-Engling L, Schlicht KF, Kotsiari A, Dreimüller N, Kleimann A, Bleich S, Lieb K, Frieling H (2014). Methylation of the promoter of brain-derived neurotrophic factor exon IV and antidepressant response in major depression. Mol Psychiatry 19: 281-283.