Status of minor depression or dysthymia in primary care following a randomized controlled treatment. AF: Dartmouth Medical School, Depts of Psychiatry and Community & Family Medicine, Lebanon, NH, US
Author: Oxman, Thomas E, Barrett, James E, Sengupta, Anjana, Katon, Wayne, Williams, John W Jr, Frank, Ellen, Hegel, Mark
Source:
General hospital psychiatry, 23(6), 301-310.
Describes rates of recovery and remission 3 mos after completing a randomized controlled treatment trial in 201 patients with minor depression and 229 with dysthymiSs received >=3D4 treatment sessions with Problem-Solving Treatment, paroxetine, or placebo and were assessed 3 mos after the study. The 17-item Hamilton Rating Scale for Depression, questions about postintervention depression treatments, and baseline medical comorbidity, neuroticism, and social function were the primary measures. For minor depression 76% and for dysthymia 68% of Ss who were in remission at the end of the 11-wk trial were recovered 3 mos after the trial. Of Ss who were not in remission at 11 wks, for minor depression 37% and for dysthymia 31% went on to achieve remission at 25 wks. The majority of Ss chose not to use antidepressants or psychotherapy after the trial. Ss with minor depression that had greater baseline social function and lower neuroticism scores were more likely to be recovered. Findings suggest a need for some matching of continuation and maintenance treatment to patient characteristics for patients with minor depression. Because of the chronic, relapsing nature of dysthymia, practical improvements in encouraging effective continuation and maintenance phases of treatment are indicated.