Moderators of remission with interpersonal counselling or drug treatment in primary care patients with depression: Randomised controlled trial
| Autor: | Menchetti, M., Rucci, P., Bortolotti, B., Bombi, A., Scocco, P., Kraemer, H. C., Berardi, D., Luciano, C., Lia, L., Manganaro, D., Magnani, M., Nespeca, C., Succu, M., Bellino, S., Bogetto, F., Zizza, M., Colombini, N., Rigatelli, M., Simoni, E., Tedeschin, E., Baranzini, F., Bortolaso, P., Callegari, C., Diurni, G. C. M., Vender, S., Martinelli, V., Politi, P., Sciarini, P., Piselli, Massimiliano, Quartesan, Roberto, Bellomo, A., De Salvia, M., Ferretti, M., Iuso, S., Petito, A., Affatati, V., Todarello, O., Carpiniello, B., Contu, C., Pinna, F. |
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| Přispěvatelé: | M Menchetti, P Rucci, B Bortolotti, A Bombi, P Scocco, HC Kraemer, D Berardi, DEPICS group |
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
Counseling SYMPTOMS Outcome Assessment MAJOR DEPRESSION ANTIDEPRESSANT MEDICATION COGNITIVE THERAPY MENTAL DISORDERS PROBLEM SOLVING TREATMENT PSYCHOTHERAPY PHARMACOTHERAPY SIZE LIFE INTERPERSONAL COUNSELLING Anxiety Severity of Illness Index law.invention 0302 clinical medicine Randomized controlled trial PRIMARY CARE law Outcome Assessment Health Care Activities of Daily Living 030212 general & internal medicine Depression (differential diagnoses) Remission Induction Smoking Middle Aged DEPRESSION ANTIDEPRESSANTS Intention to Treat Analysis Psychiatry and Mental health Brief Practice Guidelines as Topic Serotonin Uptake Inhibitors Female Adult Depressive Disorder Major Effect Modifier Epidemiologic Humans Logistic Models Outcome Assessment (Health Care) Patient Selection Primary Health Care Psychiatric Status Rating Scales Psychotherapy Brief Social Adjustment medicine.symptom Psychology Selective Serotonin Reuptake Inhibitors medicine.medical_specialty 03 medical and health sciences Internal medicine Severity of illness medicine Psychiatry Depressive Disorder Intention-to-treat analysis Epidemiologic Hamilton Rating Scale for Depression Major moderator medicine.disease Comorbidity 030227 psychiatry Clinical trial Effect Modifier Health Care Psychotherapy |
| Popis: | BackgroundDespite 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.AimsTo 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.MethodA 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.ResultsThe 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.ConclusionsWe 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: | OpenAIRE |
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