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Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years.

Publication ,  Journal Article
Barrett, JE; Williams, JW; Oxman, TE; Frank, E; Katon, W; Sullivan, M; Hegel, MT; Cornell, JE; Sengupta, AS
Published in: J Fam Pract
May 2001

OBJECTIVE: The researchers evaluated the effectiveness of paroxetine and Problem-Solving Treatment for Primary Care (PST-PC) for patients with minor depression or dysthymia. STUDY DESIGN: This was an 11-week randomized placebo-controlled trial conducted in primary care practices in 2 communities (Lebanon, NH, and Seattle, Wash). Paroxetine (n=80) or placebo (n=81) therapy was started at 10 mg per day and increased to a maximum 40 mg per day, or PST-PC was provided (n=80). There were 6 scheduled visits for all treatment conditions. POPULATION: A total of 241 primary care patients with minor depression (n=114) or dysthymia (n=127) were included. Of these, 191 patients (79.3%) completed all treatment visits. OUTCOMES: Depressive symptoms were measured using the 20-item Hopkins Depression Scale (HSCL-D-20). Remission was scored on the Hamilton Depression Rating Scale (HDRS) as less than or equal to 6 at 11 weeks. Functional status was measured with the physical health component (PHC) and mental health component (MHC) of the 36-item Medical Outcomes Study Short Form. RESULTS: All treatment conditions showed a significant decline in depressive symptoms over the 11-week period. There were no significant differences between the interventions or by diagnosis. For dysthymia the remission rate for paroxetine (80%) and PST-PC (57%) was significantly higher than for placebo (44%, P=.008). The remission rate was high for minor depression (64%) and similar for each treatment group. For the MHC there were significant outcome differences related to baseline level for paroxetine compared with placebo. For the PHC there were no significant differences between the treatment groups. CONCLUSIONS: For dysthymia, paroxetine and PST-PC improved remission compared with placebo plus nonspecific clinical management. Results varied for the other outcomes measured. For minor depression, the 3 interventions were equally effective; general clinical management (watchful waiting) is an appropriate treatment option.

Duke Scholars

Published In

J Fam Pract

ISSN

0094-3509

Publication Date

May 2001

Volume

50

Issue

5

Start / End Page

405 / 412

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Remission Induction
  • Psychotherapy
  • Psychiatric Status Rating Scales
  • Problem Solving
  • Primary Health Care
  • Paroxetine
  • Middle Aged
  • Male
 

Citation

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Barrett, J. E., Williams, J. W., Oxman, T. E., Frank, E., Katon, W., Sullivan, M., … Sengupta, A. S. (2001). Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years. J Fam Pract, 50(5), 405–412.
Barrett, J. E., J. W. Williams, T. E. Oxman, E. Frank, W. Katon, M. Sullivan, M. T. Hegel, J. E. Cornell, and A. S. Sengupta. “Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years.J Fam Pract 50, no. 5 (May 2001): 405–12.
Barrett JE, Williams JW, Oxman TE, Frank E, Katon W, Sullivan M, et al. Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years. J Fam Pract. 2001 May;50(5):405–12.
Barrett, J. E., et al. “Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years.J Fam Pract, vol. 50, no. 5, May 2001, pp. 405–12.
Barrett JE, Williams JW, Oxman TE, Frank E, Katon W, Sullivan M, Hegel MT, Cornell JE, Sengupta AS. Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years. J Fam Pract. 2001 May;50(5):405–412.

Published In

J Fam Pract

ISSN

0094-3509

Publication Date

May 2001

Volume

50

Issue

5

Start / End Page

405 / 412

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Severity of Illness Index
  • Remission Induction
  • Psychotherapy
  • Psychiatric Status Rating Scales
  • Problem Solving
  • Primary Health Care
  • Paroxetine
  • Middle Aged
  • Male