Objective To evaluate the efficacy of emotional support and counselling combined with placebo or antidepressants with single or dual mechanism of action in the treatment of depression in primary care.
Setting Several locations in Norway.
Subjects 372 patients with depression.
Main outcome measures Improvement (clinical remission) reported both by the patient (Montgomery Asberg depression rating scale) and the physician (clinical global improvement and impression scales).
Results Intention to treat analyses showed 47% remission in patients randomised to placebo compared with 61% remission in patients randomised to sertraline (odds ratio 0.56,95% confidence interval 0.33 to 0.96) and 54% in patients randomised to mianserin (0.75,0.44 to 1.27).
Women responded better than men (1.86,1.17 to 2.96).
Subgroup analyses showed that subjects with recurrent depression (n=273) responded more frequently to sertraline than to placebo (0.43,0.23 to 0.82) than those having their first episode of depression (1.18,0.39 to 3.61).
Statistically significant interactions between type of drug treatment and history of depression were not shown by logistic regression.
Conclusion The combination of active drug and simple psychological treatment (counselling, emotional support, and close follow up over a 24 week period) was more effective than simple psychological treatment alone, in particular for those with recurrent depression. (...)
Mots-clés Pascal : Etat dépressif, Etude double insu, Randomisation, Chimiothérapie, Association, Conseil psychologique, Emotional Attachment Scale, Evaluation, Critère décision, Homme, Etude longitudinale, Norvège, Europe, Médecine générale, Soin intégré, Système nerveux pathologie, Psychopathologie, Psychiatrie
Mots-clés Pascal anglais : Depression, Double blind study, Randomization, Chemotherapy, Association, Psychological counseling, Emotional Attachment Scale, Evaluation, Decision criterion, Human, Follow up study, Norway, Europe, Internal medicine, Managed care, Nervous system diseases, Psychopathology, Psychiatry
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0270011
Code Inist : 002B02B02. Création : 16/11/1999.