Raymond W Lam1, Sagar V Parikh, Rajamannar Ramasubbu, Erin E Michalak, Edwin M Tam, Auby Axler, Lakshmi N Yatham, Sidney H Kennedy, Chinnapalli V Manjunath. 1. Raymond W. Lam, MD, Department of Psychiatry, University of British Columbia, UBC Hospital, Vancouver, British Columbia; Sagar V. Parikh, MD, Department of Psychiatry, University of Toronto, University Health Network, Toronto, Ontario; Rajamannar Ramasubbu, MD, Department of Psychiatry, University of Calgary, Calgary, Alberta; Erin E. Michalak, PhD, Edwin M. Tam, MD, Auby Axler, MD, Lakshmi N. Yatham, MBBS, Department of Psychiatry, University of British Columbia, UBC Hospital, Vancouver, British Columbia; Sidney H. Kennedy, MD, Department of Psychiatry, University of Toronto, University Health Network, Toronto, Ontario; Chinnapalli V. Manjunath, MD, Department of Psychiatry, University of British Columbia, Surrey Memorial Hospital, Surrey, British Columbia, Canada.
Abstract
BACKGROUND:Major depressive disorder is associated with significant impairment in occupational functioning and reduced productivity, which represents a large part of the overall burden of depression. AIMS: To examine symptom-based and work functioning outcomes with combined pharmacotherapy and psychotherapy treatment of major depressive disorder. METHOD:Employed patients with a DSM-IV diagnosis of major depressive disorder were treated with escitalopram 10-20 mg/day and randomised to: (a) telephone-administered cognitive-behavioural therapy (telephone CBT) (n = 48); or (b) adherence-reminder telephone calls (n = 51). Outcomes included the Montgomery-Åsberg Depression Rating Scale (MADRS), administered by masked evaluators via telephone, and self-rated work functioning scales completed online. (Registered at clinicaltrials.gov: NCT00702598.) RESULTS: After 12 weeks, there were no significant between-group differences in change in MADRS score or in response/remission rates. However, participants in the telephone-CBT group had significantly greater improvement on some measures of work functioning than the escitalopram-alone group. CONCLUSIONS: Combined treatment with escitalopram and telephone-administered CBT significantly improved some self-reported work functioning outcomes, but not symptom-based outcomes, compared with escitalopram alone.
RCT Entities:
BACKGROUND: Major depressive disorder is associated with significant impairment in occupational functioning and reduced productivity, which represents a large part of the overall burden of depression. AIMS: To examine symptom-based and work functioning outcomes with combined pharmacotherapy and psychotherapy treatment of major depressive disorder. METHOD: Employed patients with a DSM-IV diagnosis of major depressive disorder were treated with escitalopram 10-20 mg/day and randomised to: (a) telephone-administered cognitive-behavioural therapy (telephone CBT) (n = 48); or (b) adherence-reminder telephone calls (n = 51). Outcomes included the Montgomery-Åsberg Depression Rating Scale (MADRS), administered by masked evaluators via telephone, and self-rated work functioning scales completed online. (Registered at clinicaltrials.gov: NCT00702598.) RESULTS: After 12 weeks, there were no significant between-group differences in change in MADRS score or in response/remission rates. However, participants in the telephone-CBT group had significantly greater improvement on some measures of work functioning than the escitalopram-alone group. CONCLUSIONS: Combined treatment with escitalopram and telephone-administered CBT significantly improved some self-reported work functioning outcomes, but not symptom-based outcomes, compared with escitalopram alone.
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