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Measurement-based care versus standard care for major depression: A randomized controlled trial with blind raters
Guo T.; Xiang Y.-T.; Xiao L.; Hu C.-Q.; Chiu H.F.K.; Ungvari G.S.; Correll C.U.; Lai K.Y.C.; Feng L.; Geng Y.; Feng Y.; Wang G.
2015
Source PublicationAmerican Journal of Psychiatry
ISSN0002953X
Volume172Issue:10Pages:1004
Abstract

Objective: The authors compared measurement-based care with standard treatment in major depression. Methods: Outpatients with moderate to severe major depression were consecutively randomized to 24 weeks of either measurement-based care (guideline- and rating scalebased decisions; N=61), or standard treatment (clinicians? choice decisions; N=59). Pharmacotherapy was restricted to paroxetine (20?60mg/day) or mirtazapine (15?45mg/day) in both groups. Depressive symptoms were measured with the Hamilton Depression Rating Scale (HAM-D) and the Quick InventoryofDepressiveSymptomatology? Self-Report (QIDS-SR). Time to response (a decrease of at least 50% in HAM-Dscore) and remission (a HAM-D score of 7 or less) were the primary endpoints. Outcomes were evaluated by raters blind to study protocol and treatment. Results: Significantly more patients in the measurementbased care group than in the standard treatment group achieved response (86.9% compared with 62.7%) and remission (73.8% compared with 28.8%). Similarly, time to response and remission were significantly shorter with measurement-based care (for response, 5.6 weeks compared with 11.6 weeks, and for remission, 10.2 weeks comparedwith 19.2weeks).HAM-Dscores decreasedsignificantly in both groups, but the reduction was significantly larger for the measurement-based care group (217.8 compared with 213.6). The measurement-based care group had significantlymoretreatment adjustments (44comparedwith 23) and higher antidepressant dosages from week 2 to week 24. Rates of study discontinuation, adverse effects, and concomitant medications did not differ between groups. Conclusions: The results demonstrate the feasibility and effectiveness of measurement-based care for outpatients with moderate to severe major depression, suggesting that this approach can be incorporated in the clinical care of patients with major depression.

DOIhttp://doi.org/10.1176/appi.ajp.2015.14050652
URLView the original
Indexed BySCI
Language英语
WOS Research AreaPsychiatry
WOS SubjectPsychiatry
WOS IDWOS:000362151100014
The Source to ArticleScopus
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被引频次[WOS]:62   [WOS记录]     [WOS相关记录]
Document TypeJournal article
专题Faculty of Health Sciences
Corresponding AuthorXiang Y.-T.; Wang G.
AffiliationFrom the Mood Disorders Center and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing; the Center of Depression, Beijing Institute for Brain Disorders and China Clinical Research Center for Mental Disor
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Guo T.,Xiang Y.-T.,Xiao L.,et al. Measurement-based care versus standard care for major depression: A randomized controlled trial with blind raters[J]. American Journal of Psychiatry,2015,172(10):1004.
APA Guo T..,Xiang Y.-T..,Xiao L..,Hu C.-Q..,Chiu H.F.K..,...&Wang G..(2015).Measurement-based care versus standard care for major depression: A randomized controlled trial with blind raters.American Journal of Psychiatry,172(10),1004.
MLA Guo T.,et al."Measurement-based care versus standard care for major depression: A randomized controlled trial with blind raters".American Journal of Psychiatry 172.10(2015):1004.
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