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PW01-01 - Treatment of Atypical Depression: Post-Hoc Analysis of a Rct Testing The Efficacy Of Sertraline and Cbt in Primary Care Patients

Published online by Cambridge University Press:  17 April 2020

A.-K. Allgaier ,
R. Mergl ,
M. Hautzinger ,
R. Kohnen ,
J.C. Coyne ,
H.-J. Möller ,
U. Hegerl  and
V. Henkel
A.-K. Allgaier
Affiliation:
Department of Child and Adolescent Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany
R. Mergl
Affiliation:
Department of Psychiatry, University of Leipzig, Leipzig, Germany
M. Hautzinger
Affiliation:
Department of Psychology, Eberhard-Karls-University Tuebingen, Tuebingen, Germany
R. Kohnen
Affiliation:
RPS Research Germany GmbH, Nuremberg, Germany
J.C. Coyne
Affiliation:
Department of Psychiatry, University of Pennsylvania Health System, Philadelphia, PA, USA
H.-J. Möller
Affiliation:
Department of Psychiatry, University of Pennsylvania Health System, Philadelphia, PA, USA
U. Hegerl
Affiliation:
Department of Psychiatry, University of Leipzig, Leipzig, Germany
V. Henkel
Affiliation:
Department of Psychiatry, Ludwig-Maximilians-University Munich, Munich, Germany

Abstract

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Objectives

Atypical features are common among depressed primary care patients, but clinical trials testing the efficacy of psychopharmacological and/or psychotherapeutic treatment are lacking. This paper examines the efficacy of sertraline and cognitive behavioural therapy (CBT) among depressed patients with atypical features.

Methods

Analyses involve a double-blind comparison of sertraline versus placebo (N=47) and a single-blind comparison between CBT versus a guided self-help group (GSG) (N=48), with primary efficacy endpoints being the Inventory of Depressive Symptomatology (IDSC) and Hamilton Depression Scale (HAMD-17).

Results

In intent-to-treat (ITT) analyses, the decrease on the IDSC scale (and HAMD-17) was greater after CBT compared to GSG: p=0.01 (HAMD-17: p=0.01). The difference between SSRI versus placebo was not significant: p=0.22 (HAMD-17: p=0.36). At endpoint, the CBT versus GSG difference in mean change from baseline IDSc scores was 7.69 points (HAMD-17: 4.97 points), the sertraline versus placebo difference was 3.07 points (HAMD-17: 0.59 points).

Conclusions

The data provide a preliminary suggestion that the mix of patients with minor or mild major depression with atypical features may not be best treated with an SSRI, but that these conditions might be amenable to CBT. Although SSRI were not superior to placebo, it would be premature to rule out SSRI as efficacious in atypical depression.

Type
Affective disorders / Unipolar depression / Bipolar disorder
Information
European Psychiatry , Volume 25 , Issue S1: 18th European Congress of Psychiatry. February 27, March 2, 2010 - Munich, Germany , 2010 , 25-E1403
Copyright
Copyright © European Psychiatric Association 2010
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