title: Comparative effectiveness of medication versus cognitive-behavioral therapy in a randomized controlled trial of low-income young minority women with depression.
abstract: OBJECTIVE
  To examine whether there are latent trajectory classes in response to treatment and whether they moderate the effects of medication versus psychotherapy.
  
  
  METHODS
  Data come from a 1-year randomized controlled trial of 267 low-income, young (M = 29 years), minority (44% Black, 50% Latina, 6% White) women with current major depression randomized to antidepressants, cognitive-behavioral therapy (CBT), or referral to community mental health services. Growth mixture modeling was used to determine whether there were differential effects of medication versus CBT. Depression was measured via the Hamilton Depression Rating Scale (Hamilton, 1960).
  
  
  RESULTS
  We identified 2 latent trajectory classes. The first was characterized by severe depression at baseline. At 6 months, mean depression scores for the medication and CBT groups in this class were 13.9 and 14.9, respectively (difference not significant). At 12 months, mean depression scores were 16.4 and 11.0, respectively (p for difference = .04). The second class was characterized by moderate depression and anxiety at baseline. At 6 months, mean depression scores for the medication and CBT groups were 4.4 and 6.8, respectively (p for difference = .03). At 12 months, the mean depression scores were 7.1 and 7.8, respectively, and the difference was no longer significant.
  
  
  CONCLUSIONS
  Among depressed women with moderate baseline depression and anxiety, medication was superior to CBT at 6 months, but the difference was not sustained at 1 year. Among women with severe depression, there was no significant treatment group difference at 6 months, but CBT was superior to medication at 1 year.
authors.affiliation: Northwestern University, Chicago, IL, USA. siddique@northwestern.edu
authors.forename: Juned
authors.initials: J
authors.lastname: Siddique
authors.forename: Joyce Y
authors.initials: JY
authors.lastname: Chung
authors.forename: C Hendricks
authors.initials: CH
authors.lastname: Brown
authors.forename: Jeanne
authors.initials: J
authors.lastname: Miranda
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000627:therapeutic use*; D015928:Cognitive Behavioral Therapy; D003156:Community Mental Health Services; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008913:Minority Groups / Q000523:psychology*; D011203:Poverty; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents