Article2009

Effects of pharmacotherapy and psychotherapy in depressed primary-care patients: a randomized, controlled trial including a patients' choice arm

Ulrich Hegerl · Martin Hautzinger · Roland Mergl · Ralf Kohnen · Winfried Scheunemann · Antje‐Kathrin Allgaier +2 more

107 citations0/0 files storedThe International Journal of Neuropsychopharmacology

No readable copy stored yet — this record is metadata only.

No open-access location is known for this record yet.

Literature note Cite in a project Citation map

Psychotherapy Techniques and Applications Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes Treatment of Major Depression

Abstract

Mild depressive syndromes are highly prevalent among primary-care patients. Evidence-based treatment recommendations need to be derived directly from this diagnostically heterogeneous group. The primary aim was to assess the efficacy of sertraline and cognitive-behavioural group therapy for treatment of depressed primary-care patients, the secondary aim was to evaluate if receiving treatment according to free choice is associated with a better outcome than randomization to a particular treatment. We conducted a randomized, placebo-controlled, single-centre, 10-wk trial with five arms: sertraline (flexible dosages up to 200 mg/d) (n = 83); placebo (n = 83); manual-guided cognitive-behavioural group therapy (one individual session and nine group sessions per 90 min) (n = 61); guided self-help group (control condition, n = 59); and treatment with sertraline or cognitive-behavioural group therapy according to patients' choice (n = 82). From 1099 consecutively screened adult patients, 368 formed the intent-to-treat population with milder forms of depression. Primary outcome was a global efficacy measure combining z-converted Hamilton Depression Rating Scale and clinician-rated Inventory for Depressive Symptomatology scores. Sertraline was superior to placebo (p = 0.03). Outcome for guided self-help groups was worse compared to cognitive-behavioural group therapy (p = 0.002) and compared to all other treatment arms including pill placebo (secondary analyses). Outcome in the patients' choice arm was similar to that in the sertraline and cognitive-behavioural group therapy. Overall, sertraline is efficacious in primary-care patients with milder forms of depression. The superiority of cognitive-behavioural group therapy over guided self-help groups might partly be explained by 'nocebo' effects of the latter.

Paper brief

Loading…

Cite this work

Citation unavailable for this work.

BibTeX RIS CSL-JSON

No public copy is stored for this record, so only the metadata is cited.

Citations in this library

Citation map →

Stored only when both papers are in the corpus — 107 citations exist upstream.

References

1960A RATING SCALE FOR DEPRESSION 2002Collaborative Care Management of Late-Life Depression in the Primary Care Setting 1989National Institute of Mental Health Treatment of Depression Collaborative Research Program 2006Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression.2005Size and burden of mental disorders in Europe—a critical review and appraisal of 27 studies 1986The inventory for depressive symptomatology (IDS): Preliminary findings 2000Handbook of Psychiatric Measures 1997Prevalence, correlates, and course of minor depression and major depression in the national comorbidity survey

Cited by

2013Comparison of psychotherapies for adult depression to pill placebo control groups: a meta-analysis 2011Depression beliefs, treatment preference, and outcomes in a randomized trial for major depressive disorder 2017Initial severity of depression and efficacy of cognitive–behavioural therapy: Individual-participant data meta-analysis of pill-placebo-controlled trials

Explore the map →

Papers that cite the same references — the relational fallback while embeddings are still backfilling.

Imported from OpenAlex (CC0) — nothing here is generated.