title: Moderators of remission with interpersonal counselling or drug treatment in primary care patients with depression: randomised controlled trial.
abstract: BACKGROUND
  Despite depressive disorders being very common there has been little research to guide primary care physicians on the choice of treatment for patients with mild to moderate depression.
  
  
  OBJECTIVE
  To evaluate the efficacy of interpersonal counselling compared with selective serotonin reuptake inhibitors (SSRIs), in primary care attenders with major depression and to identify moderators of treatment outcome.
  
  
  METHODS
  A randomised controlled trial in nine centres (DEPICS, Australian New Zealand Clinical Trials Registry number: ACTRN12608000479303). The primary outcome was remission of the depressive episode (defined as a Hamilton Rating Scale for Depression score ≤7 at 2 months). Daily functioning was assessed using the Work and Social Adjustment Scale. Logistic regression models were used to identify moderators of treatment outcome.
  
  
  RESULTS
  The percentage of patients who achieved remission at 2 months was significantly higher in the interpersonal counselling group compared with the SSRI group (58.7% v. 45.1%, P = 0.021). Five moderators of treatment outcome were found: depression severity, functional impairment, anxiety comorbidity, previous depressive episodes and smoking habit.
  
  
  CONCLUSIONS
  We identified some patient characteristics predicting a differential outcome with pharmacological and psychological interventions. Should our results be confirmed in future studies, these characteristics will help clinicians to define criteria for first-line treatment of depression targeted to patients' characteristics.
authors: Marco Menchetti, MD, Institute of Psychiatry, University of Bologna, Bologna, Italy; Paola Rucci, PhD, Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy; Biancamaria Bortolotti, MD, PhD, Annarosa Bombi, MD, Institute of Psychiatry, University of Bologna, Bologna, Italy; Paolo Scocco, MD, Mental Health Department, Local Social and Health Unit, Padova, Italy; Helena Chmura Kraemer, PhD, Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California, USA; Domenico Berardi, MD, Institute of Psychiatry, University of Bologna, Bologna, Italy.
authors: Marco
authors: M
authors: Menchetti
authors: Paola
authors: P
authors: Rucci
authors: Biancamaria
authors: B
authors: Bortolotti
authors: Annarosa
authors: A
authors: Bombi
authors: Paolo
authors: P
authors: Scocco
authors: Helena Chmura
authors: HC
authors: Kraemer
authors: Domenico
authors: D
authors: Berardi
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D001007:Anxiety / Q000453:epidemiology; D003376:Counseling; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology* / Q000628:therapy; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006801:Humans; D057194:Intention to Treat Analysis; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods*; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D011614:Psychotherapy, Brief / Q000379:methods*; D012074:Remission Induction; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D012907:Smoking / Q000453:epidemiology; D012917:Social Adjustment
chemical_list: D017367:Selective Serotonin Reuptake Inhibitors