Document Detail

Differential effects of treatments for chronic depression: a latent growth model reanalysis.
MedLine Citation:
PMID:  20515216     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Psychotherapy-pharmacotherapy combinations are frequently recommended for the treatment of chronic depressive disorders. Our aim in this novel reanalysis of archival data was to identify patient subgroups on the basis of symptom trajectories and examine the clinical significance of the resultant classification on basis of differential treatment effects to psychotherapy (cognitive behavioral analysis system of psychotherapy), pharmacotherapy (nefazodone), and their combination. METHOD: We selected data for 504 patients diagnosed with chronic depression from archival data of a clinical trial (N = 681) and analyzed treatment courses (as assessed by the Hamilton Rating Scale for Depression) using growth mixture models, a contemporary exploratory analysis technique. RESULTS: Three patient subgroups were identified from the typical patterns of change of depression severity during 12-week acute-phase treatment. Within these patient subgroups, differential treatment effects were evident: combination treatment clearly outperformed the 2 monotherapies in the largest patient subgroup, characterized by moderate depression severity, but not in the remaining 2 subgroups, characterized by low and severe depression at baseline. Patient characteristics prior to initiation of treatment enabled allocation of 61% of patients to these subgroups. CONCLUSIONS: Research on patient subgroups with different change patterns may support classifications of patients that indicate which treatment is most effective for which type of patient.
Niklaus Stulz; Michael E Thase; Daniel N Klein; Rachel Manber; Paul Crits-Christoph
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of consulting and clinical psychology     Volume:  78     ISSN:  1939-2117     ISO Abbreviation:  J Consult Clin Psychol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-02     Completed Date:  2010-09-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0136553     Medline TA:  J Consult Clin Psychol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  409-19     Citation Subset:  IM    
Department of Psychiatry, University of Pennsylvania Philadelphia, PA 19104, USA.
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MeSH Terms
Antidepressive Agents, Second-Generation / adverse effects,  therapeutic use*
Chronic Disease
Cognitive Therapy*
Combined Modality Therapy
Depressive Disorder, Major / diagnosis,  psychology,  therapy*
Dysthymic Disorder / diagnosis,  psychology,  therapy*
Middle Aged
Models, Psychological
Personality Inventory / statistics & numerical data
Recurrence / prevention & control
Triazoles / adverse effects,  therapeutic use*
Reg. No./Substance:
0/Antidepressive Agents, Second-Generation; 0/Triazoles; 83366-66-9/nefazodone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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