Effects of Patient Preferences on Outcomes in the Predictors of Remission in Depression to Individual and Combined Treatments (PReDICT) Study
| Autor: | Boadie W. Dunlop, Becky Kinkead, Tanja Mletzko-Crowe, Vivianne Aponte-Rivera, W. Edward Craighead, Helen S. Mayberg, Charles B. Nemeroff, Mary E. Kelley, James C. Ritchie |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Randomization Psychometrics medicine.medical_treatment Citalopram Duloxetine Hydrochloride 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine Internal medicine Outcome Assessment Health Care mental disorders medicine Humans Duloxetine Escitalopram Psychiatry Depression (differential diagnoses) Psychiatric Status Rating Scales Depressive Disorder Major Cognitive Behavioral Therapy Patient Preference Middle Aged medicine.disease Combined Modality Therapy Antidepressive Agents 030227 psychiatry Psychiatry and Mental health Treatment Outcome chemistry Cognitive therapy Major depressive disorder Female Psychology 030217 neurology & neurosurgery medicine.drug |
| Zdroj: | American Journal of Psychiatry. 174:546-556 |
| ISSN: | 1535-7228 0002-953X |
| Popis: | The Predictors of Remission in Depression to Individual and Combined Treatments [PReDICT] study aimed to identify clinical and biological factors predictive of treatment outcomes in major depressive disorder among treatment-naive adults. The authors evaluated the efficacy of cognitive-behavioral therapy (CBT) and two antidepressant medications (escitalopram and duloxetine) in patients with major depression and examined the moderating effect of patients' treatment preferences on outcomes.Adults aged 18-65 with treatment-naive major depression were randomly assigned with equal likelihood to 12 weeks of treatment with escitalopram (10-20 mg/day), duloxetine (30-60 mg/day), or CBT (16 50-minute sessions). Prior to randomization, patients indicated whether they preferred medication or CBT or had no preference. The primary outcome was change in the 17-item Hamilton Depression Rating Scale (HAM-D), administered by raters blinded to treatment.A total of 344 patients were randomly assigned, with a mean baseline HAM-D score of 19.8 (SD=3.8). The mean estimated overall decreases in HAM-D score did not significantly differ between treatments (CBT: 10.2, escitalopram: 11.1, duloxetine: 11.2). Last observation carried forward remission rates did not significantly differ between treatments (CBT: 41.9%, escitalopram: 46.7%, duloxetine: 54.7%). Patients matched to their preferred treatment were more likely to complete the trial but not more likely to achieve remission.Treatment guidelines that recommend either an evidence-based psychotherapy or antidepressant medication for nonpsychotic major depression can be extended to treatment-naive patients. Treatment preferences among patients without prior treatment exposure do not significantly moderate symptomatic outcomes. |
| Databáze: | OpenAIRE |
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