Finding Evidence · Depression

Are all antidepressants equal?

November 12, 2009 in Depression by Christina.Sullivan

Evid Based Ment Health. 2009 Nov;12(4):98-100

Danube University, Department for Evidence-based Medicine and Clinical Epidemiology, Krems, Austria. gerald.gartlehner@donau-uni.ac.at

Primary care physicians and psychiatrists manage the majorityof patients suffering from acute phase major depressive disorder(MDD). For most patients, antidepressant treatment is the primarychoice of care. Second generation antidepressants (SGAs)—developedfollowing the first generation of tricyclic and monoamine oxidaseagents—have become the preferred drug choice because oftheir greater tolerability, lower risk of lethality and similarefficacy compared with first generation agents. (More)

Pediatric depression: is there evidence to improve evidence-based treatments?

July 21, 2009 in Children, Depression by Christina.Sullivan

J Child Psychol Psychiatry. 2009 Jan;50(1-2):143-52

Brent DA, Maalouf FT.

University of Pittsburgh Medical Center, 200 Lothrop St., Pittsburgh, PA 15213-2582, USA. sughrueb@upmc.edu

Although there have been advances in our ability to treat child and adolescent depression, use of evidence-based treatments still results in many patients with residual symptoms. Advances in our understanding of cognitive, emotional, and ecological aspects of early-onset depression have the potential to lead to improvements in the assessment and treatment of depression. (More)

Mental health treatment of child abuse and neglect: the promise of evidence-based practice

June 1, 2009 in Children, Depression, Abuse & neglect by Christina.Sullivan

Pediatr Clin North Am. 2009 Apr;56(2):417-28

Shipman K, Taussig H.

University of Colorado, School of Medicine, The Kempe Center for the Prevention and Treatment of Child Abuse and Neglect, The Gary Pavillion at the Children’s Hospital, Anschutz Medical Campus, Aurora, CO 80045, USA.

In 2006, 3.6 million children in the United States received a child protective services’ investigation and 905,000 children (about one-quarter of those investigated) were found to have been abused or neglected. Children who have been maltreated are at risk for experiencing a host of mental health problems . . . (More)

When should psychotherapy be the treatment of choice for major depressive disorder?

March 10, 2009 in FrontPage, Depression, Practice by Christina.Sullivan

Curr Psychiatry Rep. 2008 Dec;10(6):452-7

Markowitz JC.

New York State Psychiatric Institute, 1051 Riverside Drive, Unit #129, New York, NY 10032, USA. jcm42@columbia.edu

Clinicians should think carefully before deciding on the initial treatment for a patient with major depressive disorder. The author argues that this does not happen often enough, and that psychotherapy may be overlooked too often as a first treatment option. Based on the research literature and the American Psychiatric Association Practice Guidelines, this article reviews potential cautions and relative indications for initiating treatment with evidence-based psychotherapies for major depressive disorder. (More)

Do antidepressants really work? A clinicians’ guide to evaluating the evidence

March 10, 2009 in FrontPage, Depression, Practice by Christina.Sullivan

Curr Psychiatry Rep. 2008 Dec;10(6):487-94

Thase ME.

University of Pennsylvania School of Medicine, 3535 Market Street, Suite 670, Philadelphia, PA 19104, USA. thase@mail.med.upenn.edu

Although antidepressants represent the cornerstone of medical management of major depressive disorder, several widely publicized recent developments have called into question the safety and effectiveness of the antidepressant medications. This article reviews the methods used to conduct studies of antidepressant efficacy, with particular focus on the research conducted by the pharmaceutical industry. (More)

Treating depression to full remission

March 10, 2009 in Depression by Christina.Sullivan

J Clin Psychiatry. 2009 Jan;70(1):e01

Trivedi MH.

Department of Mood Disorders Research Program and Clinic, University of Texas Southwestern Medical Center, Dallas, USA.

For more than a decade, the goal of major depressive disorder treatment has been achieving and sustaining remission, which involves complete resolution of depressive symptoms and a return to previous levels of mental and physical functioning. By implementing measurement-based care, clinicians may better assess patient response to treatment. (More)

Evidence-Based Psychosocial Treatments for Children and Adolescents: A Ten Year Update

September 29, 2008 in FrontPage, Children, Substance Abuse, Depression, ADHD, Anxiety Disorders by Christina.Sullivan | No comments

Journal of Clinical Child and Adolescent Psychology. 2008 Jan-Mar; 37(1). Special Issue

This special issue is devoted to articles on evidence-based psychosocial treatments for children and adoescents. Articles include evidence based treatments for early autism, eating disorders, depression, anxiety disorders, OCD, traumatic events, ADHD, disruptive behavior, substance abuse and treatments for ethnic minority youth.

Are psychological treatments for depression in primary care cost-effective?

August 20, 2008 in Depression, Mental health services, Practice by Christina.Sullivan | No comments

J Ment Health Policy Econ. 2008 Mar;11(1):3-15

BACKGROUND: Depression is a highly prevalent condition that is associated with high levels of work absenteeism and high health care costs. Most patients are treated in primary care. A large group of patients prefers psychological treatments to antidepressants. AIMS OF THE STUDY: To systematically review the evidence for the cost-effectiveness of psychological treatments, psychotherapy and counselling, in comparison with usual care or antidepressant treatment in adult primary care patients with depression. (More)

Effectiveness of antidepressants: an evidence myth constructed from a thousand randomized trials?

July 25, 2008 in FrontPage, Depression, Practice by Christina.Sullivan | No comments

Philos Ethics Humanit Med. 2008 May 27;3:14

Ioannidis JP.

Clinical Trials and Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine and the Biomedical Research Institute, Foundation for Research and Technology-Hellas, Ioannina, Greece. jioannid@cc.uoi.gr

Antidepressants, in particular newer agents, are among the most widely prescribed medications worldwide with annual sales of billions of dollars. The introduction of these agents in the market has passed through seemingly strict regulatory control. Over a thousand randomized trials have been conducted with antidepressants. Statistically significant benefits have been repeatedly demonstrated and the medical literature is flooded with several hundreds of “positive” trials (both pre-approval and post-approval). However, two recent meta-analyses question this picture. (Complete article)

Depression in young people: description, assessment and evidence-based treatment

July 18, 2008 in FrontPage, Children, Depression by Christina.Sullivan | No comments

Dev Neurorehabil. 2008 Jan-Mar;11(1):3-15

Carr A.

School of Psychology, College of Human Sciences, University College Dublin, Dublin, Ireland. alan.carr@ucd.ie

OBJECTIVE: The literature on depression in children and adolescents was reviewed to provide an update for clinicians. REVIEW PROCESS: Literature of particular relevance to evidence-based practice was selected for critical review. Meta-analyses and controlled trials were prioritized for review along with key assessment instruments. OUTCOMES: An up-to-date overview of clinical features, epidemiology, prognosis, aetiology, assessment and intervention was provided. (More)

Selective serotonin reuptake inhibitors for unipolar depression: a systematic review of classic long-term randomized controlled trials

June 10, 2008 in FrontPage, Depression by Christina.Sullivan

CMAJ. 2008 May 6;178(10):1293-301

Comment in:

CMAJ. 2008 May 6;178(10):1257-60.

CMAJ. 2008 May 6;178(10):1313-5.

Deshauer D, Moher D, Fergusson D, Moher E, Sampson M, Grimshaw J.

Department of Psychiatry, University of Ottawa, Ottawa, Ont. deshauer1@sympatico.ca

BACKGROUND: Selective serotonin reuptake inhibitors are increasingly used in the long-term treatment of depression. Much of the supporting evidence about the effects of these drugs comes from discontinuation trials, a variant of randomized controlled trials whose design is problematic to interpret. We conducted a systematic review to examine the efficacy and acceptability of long-term therapy with selective serotonin reuptake inhibitors relative to placebo in the treatment of unipolar depression. (Complete article)

Public attitudes towards prevention of depression

March 19, 2008 in Adults, Depression, Mental health services by Christina.Sullivan | No comments

J Affect Disord. 2008 Mar;106(3):257-63. Epub 2007 Jul 27

Schomerus G, Angermeyer MC, Matschinger H, Riedel-Heller SG.

Department of Psychiatry, Leipzig University, Johannissallee 20, 04317 Leipzig, Germany. georg.schomerus@medizin.uni-leipzig.de

BACKGROUND: Various programs for depression prevention have been shown to be effective, but preventive efforts population wide are only beginning. We examine public attitudes towards prevention of depression and beliefs about helpful preventive measures. (More)

Primary and secondary effects of parenting and stress management interventions for parents of children with developmental disabilities: a meta-analysis

March 12, 2008 in Adults, Children, Depression, MR/DD by Christina.Sullivan | No comments

Ment Retard Dev Disabil Res Rev. 2007;13(4):357-69

Singer GH, Ethridge BL, Aldana SI.

Gevirtz Graduate School of Education, Department of Education, University of California, Santa Barbara, Santa Barbara, CA 93106-9490, USA. singer@education.ucsb.edu <singer@education.ucsb.edu>

A meta-analysis of the group intervention research for parents of children with developmental disabilities was conducted in order to characterize the efficacy of treatments in reducing depressive symptoms and other forms of psychological distress associated with stress in parents of children with developmental disabilities. (More)

Does Interpersonal Psychotherapy improve clinical care for adolescents with depression attending a rural child and adolescent mental health service? Study protocol for a cluster randomised feasibility trial

February 18, 2008 in FrontPage, Children, Depression by Christina.Sullivan | No comments

BMC Psychiatry. 2007 Oct 4;7:53

Bearsley-Smith C, Browne MO, Sellick K, Villanueva EV, Chesters J, Francis K, Reddy P.

School of Psychology, Psychiatry and Psychological Medicine, Monash University, Traralgon, Victoria, Australia. Cate.Bearsley-Smith@med.monash.edu.au

BACKGROUND: Depression amongst adolescents is a costly societal problem. Little research documents the effectiveness of public mental health services in mapping this problem. Further, it is not clear whether usual care in such services can be improved via clinician training in a relevant evidence based intervention. One such intervention, found to be effective and easily learned amongst novice clinicians, is Interpersonal Psychotherapy (IPT). The study described in the current paper has two main objectives.

(Article)

Hospital Stays Related to Depression, 2005

November 20, 2007 in Depression by Christina.Sullivan | No comments

Agency for Healthcare Research and Quality, HCUP, Statistical Brief #40

The rate for patients who were hospitalized for other conditions but who also suffered from depression nearly tripled from 93 to 247 admissions per 10,000 between 1995 and 2005. During the same period, the hospitalization rate for patients who were admitted solely for treatment of depression remained relatively stable—falling slightly from 45 to 42 admissions per 10,000 people

Suicide Findings Question Link to Antidepressants

July 31, 2007 in Adults, Depression by Christina.Sullivan | No comments

By NICHOLAS BAKALAR

Published: July 10, 2007

Two large new studies in The American Journal of Psychiatry suggest that treatment of depression, either with psychotherapy or drugs, reduces the risk of suicide attempts in all age groups, especially during the first months of treatment. The findings raise further questions about possible links between antidepressant drugs and suicide.

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Collaborative care for depression: a cumulative meta-analysis and review of longer-term outcomes.

June 15, 2007 in Adults, Depression by Christina.Sullivan | No comments

Arch Intern Med. 2006 Nov 27;166(21):2314-21.

Gilbody S, Bower P, Fletcher J, Richards D, Sutton AJ.

Department of Health Sciences, University of York, York, England. sg519@york.ac.uk

BACKGROUND: Depression is common in primary care but is suboptimally managed. Collaborative care, that is, structured care involving a greater role of nonmedical specialists to augment primary care, has emerged as a potentially effective candidate intervention to improve quality of primary care and patient outcomes.

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The failure of evidence-based medicine to guide treatment of antidepressant nonresponders.

June 15, 2007 in Adults, Depression by Christina.Sullivan | No comments

J Clin Psychiatry. 2006 Dec;67(12):1833-5. Related Articles, Links

Comment on:

J Clin Psychiatry. 2006 Dec;67(12):1836-55.

Thase ME.

University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. thaseme@upmc.edu

Publication Types:

Comment

Translating the evidence on atypical depression into clinical practice.

June 15, 2007 in Adults, Depression by Christina.Sullivan | No comments

J Clin Psychiatry. 2007;68 Suppl 3:31-6. Related Articles, Links: Hyman Rapaport M.; Department of Psychiatry and Behavioral Neurosciences, Cedars-Sinai Medical Center. mark.rapaport@cshs.org; Although the introduction of selective serotonin reuptake inhibitors ushered in an era of relative comfort among clinicians in treating major depressive disorder (MDD), no one antidepressant is appropriate for all patients with depression. In patients with atypical symptoms, efficacy of therapeutic agents may be greatest for monoamine oxidase inhibitors (MAOIs).; More