Differential Effects of Treatments for Chronic Depression: A Latent Growth Model Reanalysis

Autor/inn/en	Stulz, Niklaus; Thase, Michael E.; Klein, Daniel N.; Manber, Rachel; Crits-Christoph, Paul
Titel	Differential Effects of Treatments for Chronic Depression: A Latent Growth Model Reanalysis
Quelle	In: Journal of Consulting and Clinical Psychology, 78 (2010) 3, S.409-419 (11 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0022-006X
DOI	10.1037/a0019267
Schlagwörter	Behavioral Science Research; Rating Scales; Patients; Severity (of Disability); Psychotherapy; Depression (Psychology); Drug Therapy; Classification; Cognitive Restructuring; Behavior Modification; Clinical Diagnosis; Outcomes of Treatment; Hamilton Rating Scale for Depression + Suchen Sie Ihr Suchwort? Rating-Skala; Patient; Schweregrad; Psychotherapie; Classification system; Klassifikation; Klassifikationssystem; Behaviour modification; Verhaltensänderung
Abstract	Objective: Psychotherapy-pharmacotherapy combinations are frequently recommended for the treatment of chronic depressive disorders. Our aim in this novel reanalysis of archival data was to identify patient subgroups on the basis of symptom trajectories and examine the clinical significance of the resultant classification on basis of differential treatment effects to psychotherapy (cognitive behavioral analysis system of psychotherapy), pharmacotherapy (nefazodone), and their combination. Method: We selected data for 504 patients diagnosed with chronic depression from archival data of a clinical trial (N = 681) and analyzed treatment courses (as assessed by the Hamilton Rating Scale for Depression) using growth mixture models, a contemporary exploratory analysis technique. Results: Three patient subgroups were identified from the typical patterns of change of depression severity during 12-week acute-phase treatment. Within these patient subgroups, differential treatment effects were evident: combination treatment clearly outperformed the 2 monotherapies in the largest patient subgroup, characterized by moderate depression severity, but not in the remaining 2 subgroups, characterized by low and severe depression at baseline. Patient characteristics prior to initiation of treatment enabled allocation of 61% of patients to these subgroups. Conclusions: Research on patient subgroups with different change patterns may support classifications of patients that indicate which treatment is most effective for which type of patient. (Contains 4 tables and 2 figures.) (As Provided).
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Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10