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Vol. 80, No. 1, 2011
Issue release date: December 2010
Section title: Regular Article
Psychother Psychosom 2011;80:39–47
(DOI:10.1159/000318772)

Are Treatment Preferences Relevant in Response to Serotonergic Antidepressants and Cognitive-Behavioral Therapy in Depressed Primary Care Patients? Results from a Randomized Controlled Trial Including a Patients’ Choice Arm

Mergl R. · Henkel V. · Allgaier A.-K. · Kramer D. · Hautzinger M. · Kohnen R. · Coyne J. · Hegerl U.
aDepartment of Psychiatry, University of Leipzig, Leipzig, Departments of bPsychiatry and cChild and Adolescent Psychiatry, Ludwig Maximilian University of Munich, Munich, dDepartment of Clinical Psychology, Eberhard Karl University Tübingen, Tübingen, and eRPS Research Germany GmbH, Nuremberg, Germany; fDepartment of Psychiatry, University of Pennsylvania Health System, Philadelphia, Pa., USA

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Article / Publication Details

First-Page Preview
Abstract of Regular Article

Received: 10/23/2009
Accepted: 4/7/2010
Published online: 10/23/2010

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 3

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS

Abstract

Background: Little is known about the influence of depressed patients’ preferences and expectations about treatments upon treatment outcome. We investigated whether better clinical outcome in depressed primary care patients is associated with receiving their preferred treatment. Methods: Within a randomized placebo-controlled single-centre 10-week trial with 5 arms (sertraline; placebo; cognitive-behavioral group therapy, CBT-G; moderated self-help group control; treatment with sertraline or CBT-G according to patients’ choice), outcomes for 145 primary care patients with mild-to-moderate depressive disorders according to DSM-IV criteria were investigated. Preference for medication versus psychotherapy was assessed at screening using a single item. Post-baseline difference scores for the Hamilton Depression Rating Scale (HAMD-17) were used to assess treatment outcome (mixed-model repeated-measures regression analysis). Results: Depressed patients receiving their preferred treatment (n = 63), whether sertraline or CBT-G, responded significantly better than those who did not receive their preferred therapy (n = 54; p = 0.001). The difference in outcome between both groups was 8.0 points on the HAMD-17 for psychotherapy and 2.9 points on the HAMD-17 for treatment with antidepressants. Results were not explained by differences in depression severity or dropout rates. Conclusions: Patients’ relative preference for medication versus psychotherapy should be considered when offering a treatment because receiving the preferred treatment conveys an additional and clinically relevant benefit (HAMD-17: +2.9 points for drugs; +8.0 points for CBT-G) in outcome.


  

Author Contacts

Dr. Roland Mergl
Department of Psychiatry, University of Leipzig
Semmelweisstr. 10, DE–04103 Leipzig (Germany)
Tel. +49 341 97 24556, Fax +49 341 97 24539
E-Mail Roland.Mergl@medizin.uni-leipzig.de

  

Article Information

Clinical trials registration number: NCT00226642.

Received: October 23, 2009
Accepted after revision: July 5, 2010
Published online: October 23, 2010
Number of Print Pages : 9
Number of Figures : 1, Number of Tables : 3, Number of References : 35

  

Publication Details

Psychotherapy and Psychosomatics

Vol. 80, No. 1, Year 2011 (Cover Date: December 2010)

Journal Editor: Fava G.A. (Bologna)
ISSN: 0033-3190 (Print), eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


Article / Publication Details

First-Page Preview
Abstract of Regular Article

Received: 10/23/2009
Accepted: 4/7/2010
Published online: 10/23/2010

Number of Print Pages: 9
Number of Figures: 1
Number of Tables: 3

ISSN: 0033-3190 (Print)
eISSN: 1423-0348 (Online)

For additional information: http://www.karger.com/PPS


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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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