Functional status modifies the impact of tumor necrosis factor-alpha on depression treatment response.

Background: The association between serum tumor necrosis factor-alpha (sTNF-α) levels and antidepressant treatment responses remains controversial.

Aims: This study aimed to examine the impact of sTNF-α levels on 12-week antidepressant treatment outcomes, and to explore the moderating effects of functional status on this relationship in patients with depressive disorders.

Method: We measured baseline sTNF-α and evaluated functional status with the Social and Occupational Functioning Assessment Scale (SOFAS) in 1086 patients undergoing stepwise antidepressant treatment. Remission, defined as a score of ≤7 on the Hamilton Rating Scale for Depression, was assessed at 12 weeks. Logistic regression analyses were performed to adjust for relevant covariates.

Results: Higher sTNF-α levels were significantly associated with non-remission at 12 weeks. This association was particularly evident among patients with higher SOFAS scores, whereas no significant association was observed in patients with lower SOFAS scores. The interaction between sTNF-α levels and SOFAS scores remained significant even after adjusting for relevant covariates.

Conclusions: Baseline sTNF-α levels may serve as a useful predictor of 12-week antidepressant treatment outcomes. Incorporating functional status into the predictive model enhances the accuracy of treatment response predictions.