Somaia Mohamed, MD, PhD, associate professor of psychiatry, is a co-author and a lead investigator of a groundbreaking secondary analysis of the VAST-D study, one of the largest and most influential clinical trials in the treatment of depression in recent years.
The study, now published in the Journal of Clinical Psychopharmacology and featured in a podcast, sheds light on the powerful role of positive mental health (PMH)vin predicting and improving recovery among patients with treatment-resistant depression.
Why This Matters:
While most depression research has focused on symptom reduction, this study highlights what patients say they truly want: a return to full emotional well-being — what researchers call positive mental health. Until now, few studies have systematically measured positive mental health or evaluated its influence on long-term outcomes.
About the Study:
This analysis draws on data from the VA Augmentation and Switching Treatments for Depression (VAST-D) trial, which included overv1,500 veterans randomized to three antidepressant strategies:
- Switching to bupropion (S-BUP)
- Combining with bupropion (C-BUP)
- Augmenting with aripiprazole (A-ARI)
Participants completed a new seven-item self-report positive mental health questionnaire. Researchers examined how positive mental health at baseline and over 12 weeks related to treatment response.
Key Findings:
- Lower positive mental health scores at the start of treatment were linked to more severe depression, suicidal thoughts, anxiety, PTSD, and poor quality of life.
- Higher positive mental health scores predicted greater remission and recovery.
- Positive mental health improved most with aripiprazole augmentation, and positive mental health improvements were tied directly to better treatment outcomes.
Implications:
“Targeting positive mental health may be a crucial, yet overlooked, pathway to full recovery,” Mohamed said. “This shifts the conversation from just reducing symptoms to truly helping patients flourish.”
Sources of Support:
This study was supported and conducted by the Cooperative Studies Program, Department of Veterans Affairs, VA Office of Research and Development as CSP #576, VA Augmentation, Switching Treatments for Improving Depression Outcome (VAST-D). The CSP supported the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, and approval of the manuscript; and decision to submit the manuscript for publication. Bristol Myers Squibb provided aripiprazole for use in this study. The contents of this article do not represent the views of the U.S. Department of Veterans Affairs or the United States Government.