Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).

BACKGROUND: Although mild to moderate major depressive disorder (MDD) is one of the main reasons for consulting a general practitioner (GP), there is still no international consensus on the most appropriate therapeutic approach. METHODS: The aim of this study is to evaluate the clinical effectivenes...

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Authors: Iglesias-González M, Aznar-Lou I, Peñarrubia-María MT, Gil-Girbau M, Fernández-Vergel R, Alonso J, Serrano-Blanco A, Rubio-Valera M
Format: article
Status:Published version
Publication Date:2018
Country:España
Institution:Fundació Sant Joan de Déu
Repository:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
OAI Identifier:oai:fsjd.fundanetsuite.com:p14635
Online Access:https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=14635
Access Level:Open access
Keyword:Active monitoring
Antidepressants
Depression
Primary care
Watchful waiting
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spelling Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).Iglesias-González MAznar-Lou IPeñarrubia-María MTGil-Girbau MFernández-Vergel RAlonso JSerrano-Blanco ARubio-Valera MActive monitoringAntidepressantsDepressionPrimary careWatchful waitingBACKGROUND: Although mild to moderate major depressive disorder (MDD) is one of the main reasons for consulting a general practitioner (GP), there is still no international consensus on the most appropriate therapeutic approach. METHODS: The aim of this study is to evaluate the clinical effectiveness of watchful waiting (WW) compared with the use of antidepressants (ADs) for the treatment of mild to moderate depressive symptoms in 263 primary care (PC) usual-practice patients in a 12-month pragmatic non-randomised controlled trial. Both longitudinal and per-protocol analyses were performed, through a multilevel longitudinal analysis and a sensitivity analysis. RESULTS: We observed a statistically significant time x treatment interaction in the severity of depression (Patient Health Questionnaire, PHQ-9) and disability (World Health Organization Disability Assessment Schedule, WHODAS) in favour of the AD group at 6 months but not at 12 months. The effect size of this difference was small. No statistically significant differences were observed between groups in severity of anxiety (Beck Anxiety Inventory, BAI) or health-related quality-of-life (EuroQol-5D, EQ-5D). Sensitivity analysis and per-protocol analysis showed no differences between the two groups in any of the evaluated scales. CONCLUSIONS: Superiority of either treatment (WW and AD) was not demonstrated in patients treated for depression in PC after one year of follow-up.CAMBRIDGE UNIV PRESS2018info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=14635EUROPEAN PSYCHIATRYISSN: 09249338ISSNe: 17783585reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déuinstname:Fundació Sant Joan de DéuInglésinfo:eu-repo/semantics/openAccessoai:fsjd.fundanetsuite.com:p146352026-05-27T12:37:41Z
dc.title.none.fl_str_mv Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).
title Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).
spellingShingle Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).
Iglesias-González M
Active monitoring
Antidepressants
Depression
Primary care
Watchful waiting
title_short Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).
title_full Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).
title_fullStr Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).
title_full_unstemmed Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).
title_sort Effectiveness of watchful waiting versus antidepressants for patients diagnosed of mild to moderate depression in primary care: A 12-month pragmatic clinical trial (INFAP study).
dc.creator.none.fl_str_mv Iglesias-González M
Aznar-Lou I
Peñarrubia-María MT
Gil-Girbau M
Fernández-Vergel R
Alonso J
Serrano-Blanco A
Rubio-Valera M
author Iglesias-González M
author_facet Iglesias-González M
Aznar-Lou I
Peñarrubia-María MT
Gil-Girbau M
Fernández-Vergel R
Alonso J
Serrano-Blanco A
Rubio-Valera M
author_role author
author2 Aznar-Lou I
Peñarrubia-María MT
Gil-Girbau M
Fernández-Vergel R
Alonso J
Serrano-Blanco A
Rubio-Valera M
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Active monitoring
Antidepressants
Depression
Primary care
Watchful waiting
topic Active monitoring
Antidepressants
Depression
Primary care
Watchful waiting
description BACKGROUND: Although mild to moderate major depressive disorder (MDD) is one of the main reasons for consulting a general practitioner (GP), there is still no international consensus on the most appropriate therapeutic approach. METHODS: The aim of this study is to evaluate the clinical effectiveness of watchful waiting (WW) compared with the use of antidepressants (ADs) for the treatment of mild to moderate depressive symptoms in 263 primary care (PC) usual-practice patients in a 12-month pragmatic non-randomised controlled trial. Both longitudinal and per-protocol analyses were performed, through a multilevel longitudinal analysis and a sensitivity analysis. RESULTS: We observed a statistically significant time x treatment interaction in the severity of depression (Patient Health Questionnaire, PHQ-9) and disability (World Health Organization Disability Assessment Schedule, WHODAS) in favour of the AD group at 6 months but not at 12 months. The effect size of this difference was small. No statistically significant differences were observed between groups in severity of anxiety (Beck Anxiety Inventory, BAI) or health-related quality-of-life (EuroQol-5D, EQ-5D). Sensitivity analysis and per-protocol analysis showed no differences between the two groups in any of the evaluated scales. CONCLUSIONS: Superiority of either treatment (WW and AD) was not demonstrated in patients treated for depression in PC after one year of follow-up.
publishDate 2018
dc.date.none.fl_str_mv 2018
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=14635
url https://fsjd.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=14635
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv CAMBRIDGE UNIV PRESS
publisher.none.fl_str_mv CAMBRIDGE UNIV PRESS
dc.source.none.fl_str_mv EUROPEAN PSYCHIATRY
ISSN: 09249338
ISSNe: 17783585
reponame:r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
instname:Fundació Sant Joan de Déu
instname_str Fundació Sant Joan de Déu
reponame_str r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
collection r-FSJD. Repositorio Institucional de Producción Científica de la Fundació Sant Joan de Déu
repository.name.fl_str_mv
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