Pharmacotherapy and psychotherapy in acutely depressed patients: A study of attrition patterns in a clinical trial

Remission in Major Depressive Disorder: A Comparison of Pharmacotherapy, Psychotherapy, and Control Conditions

“…The percentage of patients with chronic major depression was not reported for any of the studies. The percentage of patients with recurrent major depressive disorder ranged from 40% in one study (24) to approximately 62% in three others (21,22,26). The percentage of patients with endogenous depression ranged from 7.4% in one study (26) to approximately 35% in two others (21,22).…”

“…Published articles by the same research group that focused on the same study group were pooled to ensure the independence of studies included in our review. Our inclusion criteria were met by six main articles (21)(22)(23)(24)(25)(26) presenting efficacy data and seven companion articles (27)(28)(29)(30)(31)(32)(33) with additional relevant data.…”

“…However, it should be noted that in one study (25) all patients in the treatment-as-usual control group were considered completers unless they refused to be contacted for follow-up. Furthermore, whereas for most studies the intent-to-treat data were based on a last-observation-carriedforward analysis of all patients randomly assigned to treatment, one study (21) examined the remission status of all patients at the end of the study, including dropouts who had received further nonrandomized treatment, while in another (23) all dropouts were considered to be "not recovered. "…”

“…The mean age reported in each study ranged from 32 to 40 years, and 76.5% of the patients were female (range=68%-85%). All patients were diagnosed as having nonpsychotic major depression, albeit with various diagnostic methods, including the Research Diagnostic Criteria (based on either the Schedule for Affective Disorders and Schizophrenia [21,22] or a nonstructured clinical assessment [24]), the Structured Clinical Interview for DSM-III (23) or DSM-III-R (26), and the Diagnostic Interview Schedule for DSM-III-R (25). The mean baseline score on the Hamilton Depression Rating Scale varied between 15.3 and 19.7 in all studies except one (25).…”

“…Cognitive behavior therapy was used in three studies (22,23,26), interpersonal therapy in three (21,22,25), problem solving in one (24), and social work counseling in another (23). All psychotherapies were delivered in an individual format.…”