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SSRI plus supportive care more effective than supportive care alone for mild to moderate depression

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Question

Question:

Are selective serotonin reuptake inhibitors (SSRIs), in addition to supportive care, more effective and cost effective than supportive care alone for treating mild to moderate depression?

Patients:

220 adults (age ⩾18 years) potentially requiring treatment for a new episode of depression. Inclusions: symptoms present for ⩾8 weeks; a score of 12–19 on the 17 item Hamilton Depression Rating Scale (HDRS); ⩾1 physical symptom on the Bradford Somatic Inventory; no antidepressant treatment within the previous 12 months; and not currently receiving counselling or psychological therapy. Exclusions: severe depression (HDRS score >19); subthreshold depression (HDRS score <12); suicidal intent; significant substance misuse; score of ⩾13 on the Alcohol Use Disorders Identification Test questionnaire; and spoken or written language skills precluding participation.

Setting:

Primary care practices around three academic centres (University of Southampton, University of Liverpool, Institute of Psychiatry at King’s College London).

Intervention:

Intervention group patients were prescribed an SSRI of the general practitioner’s choice in addition to receiving supportive care delivered at 2, 4, 8 and 12 weeks. Controls received supportive care alone. Patients in both groups could be referred …

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