Can Understanding Depression Symptom Patterns Guide Next Steps in Treatment?
July 10, 2026
Individuals with depression can experience very different combinations of symptoms, even when they share the same diagnosis. These differences may also help explain why some individuals respond to treatment while others continue to experience symptoms. In this CAN-BIND-1 study, researchers looked more closely at one group of symptoms called the interest activity dimension to investigate whether this pattern of symptoms was associated with differences in treatment response.
What are symptom dimensions in depression?
Individuals with major depressive disorder can experience a wide range of symptoms, including changes in mood, sleep, energy, concentration, motivation, interest, and activity. A symptom dimension refers to a group of related symptoms that may reflect a particular aspect of depression. Looking at these dimensions can provide more detailed information about how depression presents in different people, rather than relying only on an overall depression severity score.
One symptom dimension examined in this study was the interest-activity dimension, which includes symptoms related to reduced interest, motivation, and engagement in activities. These symptoms are common in depression and can affect a person’s ability to pursue goals and participate in everyday activities. Researchers are interested in symptom dimensions because different patterns of symptoms may be associated with differences in how people respond to specific treatments.
“Interest-activity symptoms provide a potentially widely applicable tool for personalized treatment indication as they can be easily measured in routine clinical settings.”
How the Study Worked
In this study, researchers used data from the CAN-BIND-1 clinical study to investigate whether specific patterns of depressive symptoms could help predict how people respond to treatment. Participants with major depressive disorder first received the antidepressant escitalopram, and researchers monitored their symptoms to see how much they improved. The researchers then looked at the different symptoms participants were experiencing, paying particular attention to the interest-activity dimension. They wanted to know whether people with more severe difficulties with interest and activity responded differently to treatment.
For participants who did not improve enough with escitalopram alone, aripiprazole was added to their treatment. Aripiprazole is a medication that can be used alongside an antidepressant to help reduce depressive symptoms when an antidepressant alone has not provided enough improvement. The researchers then examined whether participants’ interest-activity symptoms were related to how well they responded after aripiprazole was added. By following this process, the researchers were able to explore whether the specific way a person experiences depression could provide clues about which additional treatment may be more helpful.
What Did This Study Reveal?
This study found a relationship between the interest-activity dimension and response to aripiprazole augmentation among people with major depressive disorder:
- Participants with greater difficulties with interest and activity showed a stronger response when aripiprazole was added after an inadequate response to escitalopram.
- The interest-activity dimension provided additional information about treatment response beyond overall depression severity.
Together, these findings suggest that different dimensions of depression may be linked to differences in treatment response, rather than overall depression severity alone determining how someone responds to treatment.
Why This Matters
Depression can look different from person to person, and people with similar levels of overall symptom severity may respond differently to the same treatment. This study suggests that examining specific symptom dimensions, such as interest and activity, may provide additional information about treatment response. Understanding these differences could help researchers develop more personalized approaches to treating major depressive disorder, particularly for people who do not respond adequately to an initial antidepressant.
“Generalizable predictors of treatment outcome may be useful in clinical practice as clinicians consider more intensive treatment options earlier for individuals with predicted poor outcomes. However, predictors become even more useful if there is a defined alternative treatment that is demonstrably more effective for those who have a predicted poor outcome with standard treatment.”
Limitations to Consider
Although the study found an association between the interest-activity dimension and response to aripiprazole add-on treatment, the findings do not show that these symptoms directly cause someone to respond better to the medication. The study also focused on a specific treatment pathway, in which participants first received escitalopram and then aripiprazole was added when their response was inadequate. As a result, the findings may not apply to other antidepressants, add-on treatment strategies, or individuals with major depressive disorder. Additional research is needed to determine whether the interest-activity dimension can consistently predict treatment response across different populations and clinical settings.
Final Takeaway
The findings from this CAN-BIND-1 study suggest that looking at specific symptom dimensions may provide useful information about treatment response that is not captured by overall depression severity alone. With further research, examining symptom dimensions could help researchers better understand why people with depression respond differently to treatment and contribute to more personalized approaches to treating major depressive disorder.
Citation: Uher, R., Frey, B. N., Quilty, L. C., Rotzinger, S., Blier, P., Foster, J. A., Müller, D. J., Ravindran, A. V., Soares, C. N., Turecki, G., Parikh, S. V., Milev, R., MacQueen, G., Lam, R. W., Kennedy, S. H., & on behalf of the CAN-BIND Investigator Team. (2020). Symptom dimension of interest-activity indicates need for aripiprazole augmentation of escitalopram in major depressive disorder: A CAN-BIND-1 report. The Journal of Clinical Psychiatry, 81(4). https://doi.org/10.4088/JCP.20m13229