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

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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?


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.


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


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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  • Sources of funding None reported.


  • Competing interests: None.