L Mynors-Wallis1, D Gath. 1. University of Oxford, Department of Psychiatry, Warneford Hospital.
Abstract
BACKGROUND: A randomized controlled clinical trial compared three treatments for major depression in primary care. Ninety-one patients were randomized to receive either problem-solving, or amitriptyline with standard clinical management, or drug placebo with standard clinical management. This paper examines the possible predictive value of a range of demographic clinical and personality variables in determining outcome. METHODS: To examine the interaction between treatment group and predictor variables, analyses of co-variants were carried out for two outcome measures: the Hamilton Rating Scale for Depression and the Beck Depression Inventory. Predictor variables were also entered into a stepwise forward logistic regression in which patients were categorized as recovered or not recovered. RESULTS: None of the predictor variables examined interacted with treatment to predict outcome. Patients with a longer duration of illness, chronic social difficulties, or definite, as opposed to probable, major depression had a poorer outcome at the end of treatment, irrespective of treatment group. CONCLUSIONS: The findings in this study do not enable clear guidelines to be given as to which patients with major depression in primary care might benefit from either a psychological or pharmacological treatment.
RCT Entities:
BACKGROUND: A randomized controlled clinical trial compared three treatments for major depression in primary care. Ninety-one patients were randomized to receive either problem-solving, or amitriptyline with standard clinical management, or drug placebo with standard clinical management. This paper examines the possible predictive value of a range of demographic clinical and personality variables in determining outcome. METHODS: To examine the interaction between treatment group and predictor variables, analyses of co-variants were carried out for two outcome measures: the Hamilton Rating Scale for Depression and the Beck Depression Inventory. Predictor variables were also entered into a stepwise forward logistic regression in which patients were categorized as recovered or not recovered. RESULTS: None of the predictor variables examined interacted with treatment to predict outcome. Patients with a longer duration of illness, chronic social difficulties, or definite, as opposed to probable, major depression had a poorer outcome at the end of treatment, irrespective of treatment group. CONCLUSIONS: The findings in this study do not enable clear guidelines to be given as to which patients with major depression in primary care might benefit from either a psychological or pharmacological treatment.
Authors: Natalie A Cort; Stephanie A Gamble; Phillip N Smith; Linda H Chaudron; Naiji Lu; Hua He; Nancy L Talbot Journal: Depress Anxiety Date: 2012-05-08 Impact factor: 6.505