title: The London Depression Intervention Trial. Randomised controlled trial of antidepressants v. couple therapy in the treatment and maintenance of people with depression living with a partner: clinical outcome and costs.
abstract: BACKGROUND
  Relapse of depression is associated with a criticising attitude of the patient's partner.
  
  
  OBJECTIVE
  To compare the relative efficacy and cost of couple therapy and antidepressant drugs for the treatment and maintenance of people with depression living with a critical partner.
  
  
  METHODS
  A randomised controlled trial of antidepressant drugs v. couple therapy. The subjects were 77 people meeting criteria for depression living with a critical partner.
  
  
  RESULTS
  Drop-outs were 56.8% [corrected] from drug treatment and 15% from couple therapy. Subjects' depression improved in both groups, but couple therapy showed a significant advantage, according to the Beck Depression Inventory, both at the end of treatment and after a second year off treatment. Adding the costs of the interventions to the costs of services used showed there was no appreciable difference between the two treatments.
  
  
  CONCLUSIONS
  For this group couple therapy is much more acceptable than antidepressant drugs and is at least as efficacious, if not more so, both in the treatment and maintenance phases. It is no more expensive overall.
authors.affiliation: Social Psychiatry Section, Institute of Psychiatry, London.
authors.forename: J
authors.initials: J
authors.lastname: Leff
authors.forename: S
authors.initials: S
authors.lastname: Vearnals
authors.forename: C R
authors.initials: CR
authors.lastname: Brewin
authors.forename: G
authors.initials: G
authors.lastname: Wolff
authors.forename: B
authors.initials: B
authors.lastname: Alexander
authors.forename: E
authors.initials: E
authors.lastname: Asen
authors.forename: D
authors.initials: D
authors.lastname: Dayson
authors.forename: E
authors.initials: E
authors.lastname: Jones
authors.forename: D
authors.initials: D
authors.lastname: Chisholm
authors.forename: B
authors.initials: B
authors.lastname: Everitt
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000191:economics / Q000627:therapeutic use*; D002985:Clinical Protocols; D019546:Couples Therapy / Q000379:methods*; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010352:Patient Dropouts; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents