Moderators of remission with interpersonal counselling or drug treatment in primary care patients with depression: randomised controlled trial.
| Autor: | Menchetti M; Marco Menchetti, MD, Institute of Psychiatry, University of Bologna, Bologna, Italy; Paola Rucci, PhD, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Biancamaria Bortolotti, MD, PhD, Annarosa Bombi, MD, Institute of Psychiatry, University of Bologna, Bologna, Italy; Paolo Scocco, MD, Mental Health Department, Local Social and Health Unit, Padova, Italy; Helena Chmura Kraemer, PhD, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA; Domenico Berardi, MD, Institute of Psychiatry, University of Bologna, Bologna, Italy., Rucci P, Bortolotti B, Bombi A, Scocco P, Kraemer HC, Berardi D |
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| Jazyk: | angličtina |
| Zdroj: | The British journal of psychiatry : the journal of mental science [Br J Psychiatry] 2014 Feb; Vol. 204 (2), pp. 144-50. Date of Electronic Publication: 2013 Dec 05. |
| DOI: | 10.1192/bjp.bp.112.122663 |
| Abstrakt: | Background: Despite depressive disorders being very common there has been little research to guide primary care physicians on the choice of treatment for patients with mild to moderate depression. Aims: To evaluate the efficacy of interpersonal counselling compared with selective serotonin reuptake inhibitors (SSRIs), in primary care attenders with major depression and to identify moderators of treatment outcome. Method: A randomised controlled trial in nine centres (DEPICS, Australian New Zealand Clinical Trials Registry number: ACTRN12608000479303). The primary outcome was remission of the depressive episode (defined as a Hamilton Rating Scale for Depression score ≤7 at 2 months). Daily functioning was assessed using the Work and Social Adjustment Scale. Logistic regression models were used to identify moderators of treatment outcome. Results: The percentage of patients who achieved remission at 2 months was significantly higher in the interpersonal counselling group compared with the SSRI group (58.7% v. 45.1%, P = 0.021). Five moderators of treatment outcome were found: depression severity, functional impairment, anxiety comorbidity, previous depressive episodes and smoking habit. Conclusions: We identified some patient characteristics predicting a differential outcome with pharmacological and psychological interventions. Should our results be confirmed in future studies, these characteristics will help clinicians to define criteria for first-line treatment of depression targeted to patients' characteristics. |
| Databáze: | MEDLINE |
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