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Cited by 492

The DOI matches its Crossref record; 4 of the 4 references it cites were found in a registry or an index.

Randomised controlled trial comparing problem solving treatment with amitriptyline and placebo for major depression in primary care

Open access
Mynors-Wallis, L M, Gath, D H, Lloyd-Thomas, A R, Tomlinson, D·1995·BMJ
DOI 10.1136/bmj.310.6977.441
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Abstract

Objective : To determine whether, in the treatment of major depression in primary care, a brief psychological treatment (problem solving) was (a) as effective as antidepressant drugs and more effective than placebo; (b) feasible in practice; and (c) acceptable to patients. Design : Randomised controlled trial of problem solving treatment, amitriptyline plus standard clinical management, and drug placebo plus standard clinical management. Each treatment was delivered in six sessions over 12 weeks. Setting : Primary care in Oxfordshire. Subjects : 91 patients in primary care who had major depression. Main outcome measures : Observer and self reported measures of severity of depression, self reported measure of social outcome, and observer measure of psychological symptoms at six and 12 weeks; self reported measure of patient satisfaction at 12 weeks. Numbers of patients recovered at six and 12 weeks. Results : At six and 12 weeks the difference in score on the Hamilton rating scale for depression between problem solving and placebo treatments was significant (5.3 (95% confidence interval 1.6 to 9.0) and 4.7 (0.4 to 9.0) respectively), but the difference between problem solving and amitriptyline was not significant (1.8 (−1.8 to 5.5) and 0.9 (−3.3 to 5.2) respectively). At 12 weeks 60% (18/30) of patients given problem solving treatment had recovered on the Hamilton scale compared with 52% (16/31) given amitriptyline and 27% (8/30) given placebo. Patients were satisfied with problem solving treatment; all patients who completed treatment (28/30) rated the treatment as helpful or very helpful. The six sessions of problem solving treatment totalled a mean therapy time of 3 1/2 hours. Conclusions : As a treatment for major depression in primary care, problem solving treatment is effective, feasible, and acceptable to patients. Key messages: Key messages Patient compliance with antidepressant treatment is often poor, so there is a need for a psychological treatment This study found that problem solving is an effective psychological treatment for major depression in primary care—as effective as amitriptyline and more effective than placebo Problem solving is a feasible treatment in primary care, being effective when given over six sessions by a general practitioner Problem solving treatment is acceptable to patients

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Cites

Show all 4 references

Research works printed but not linked: 21

  1. Blacker, 1988, The prevalence and treatment of depression in general practice., Psychopharmacology, 95, S14, 10.1007/BF00172624 · DOI
  2. 10.1001/jama.1989.03430070062031 · DOI · Paper page
  3. Johnson, 1977, The severity of depression in patients treated in general practice., Journal of the Royal College of General Practitioners, 27, 419
  4. Porter, 1970, Depressive illness in a general practice. A demographic study and a controlled trial of imipramine., BMJ, i, 773, 10.1136/bmj.1.5699.773 · DOI
  5. Dunn, 1981, The natural history of depression in general practice: stochastic models., Psychol Med, 11, 755, 10.1017/S003329170004126X · DOI
  6. 1978, Lancet, ii, 1347
  7. Richels, 1970, Drug treatment in depressive illness., Diseases of the Nervous System, 31, 30
  8. Blashki, 1971, Controlled trial of amitriptyline in general practice., BMJ, i, 133, 10.1136/bmj.1.5741.133 · DOI
  9. 10.1016/0165-0327(88)90075-4 · DOI · Paper page
  10. Johnson, 1981, Depression: treatment compliance in general practice., Acta Psychiatr Scand, suppl, 447, 10.1111/j.1600-0447.1981.tb00751.x · DOI
  11. 10.1192/bjp.139.3.181 · DOI · Paper page
  12. 10.1192/bjp.144.4.400 · DOI
  13. Ross, 1985, An evaluation of the effectiveness of individual and group cognitive therapy in the treatment of depressed patients in an inner city health centre., Journal of the Royal College of General Practitioners, 35, 239
  14. Scott, 1992, Edinburgh primary care depression study: treatment outcome, patient satisfaction, and cost after 16 weeks., BMJ, 304, 883, 10.1136/bmj.304.6831.883 · DOI
  15. Corney, 1981, Social work effectiveness in the management of depressed women: a clinical trial., Psychol Med, 11, 417, 10.1017/S0033291700052247 · DOI
  16. Hawton K Kirk J .Problem-solving. In: Hawton K Salkovskis P Kirk J Clark D ed.Cognitive behaviour therapy for psychiatric problems. Oxford: Oxford University Press,1989: 406–26. · DOI
  17. Spitzer, 1978, Research diagnostic criteria: rationale and reliability., Arch Gen Psychiatry, 36, 773, 10.1001/archpsyc.1978.01770300115013 · DOI
  18. 10.1111/j.2044-8260.1967.tb00530.x · DOI · Paper page
  19. Fawcett, 1987, Clinical management–imipramine/placebo administration manual., Psychopharmacol Bull, 23, 309
  20. Wing JK Hooper JE Sartorius N .The measurement and classification of psychiatric symptoms. Cambridge: Cambridge University Press,1974.
  21. 10.1192/bjp.141.1.68 · DOI

Cited by

Metadata

Authors
Mynors-Wallis, L. M., Gath, D. H., Lloyd-Thomas, A. R., & Tomlinson, D.
Venue
BMJ
Publisher
BMJ
Published
1995-02-18
Volume
310
Issue
6977
Pages
441-445
ISSN
  • 0007-1447 (ISSN-L)
  • 0959-8138
  • 1468-5833
DOI
10.1136/bmj.310.6977.441
OpenAlex
W2015006744
Cited by
492
References
4
FWCI
24.32
Type
journal article
Language
en
Open access
green
Licence
www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)

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