Patient preference compared with random allocation in short-term psychodynamic supportive psychotherapy with indicated addition of pharmacotherapy for depression.
Depressed patients randomized to psychotherapy were compared with those who had been chosen for psychotherapy in a treatment algorithm, including addition of an antidepressant in case of early nonresponse. There were no differences between randomized and by-preference patients at baseline in adherence and outcome. About half of the early nonresponders refused the additional medication. However, no clear effect of medication addition on ultimate outcome could be demonstrated. In total, 37% of the patients achieved remission. The study suggested that randomization of patients does not induce a great influence on outcome. It might be warranted to continue an initially ineffective psychotherapy for depression, because a considerable number of patients do have a pattern of delayed response.
Van
Henricus L
HL
Mentrum Depression Research Group, Mentrum Mental Health Care, Mentrum Mental Health Hospital, Amsterdam, The Netherlands. rien.van@mentrum.nl
Dekker
Jack
J
Koelen
Jurrijn
J
Kool
Simone
S
van Aalst
Gerda
G
Hendriksen
Marielle
M
Peen
Jaap
J
Schoevers
Robert
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D002755:Choice Behavior; D003131:Combined Modality Therapy; D003511:Cyclohexanols / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D011614:Psychotherapy, Brief; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D000069470:Venlafaxine Hydrochloride; D055815:Young Adult
D003511:Cyclohexanols; D017367:Selective Serotonin Reuptake Inhibitors; D000069470:Venlafaxine Hydrochloride