Randomised controlled trial comparing problem solving treatment with amitriptyline and placebo for major depression...

Area of Science:

• Psychiatry
• Primary Care Medicine
• Psychological Interventions

Background:

• Major depression is a prevalent condition in primary care settings.
• Effective and accessible treatment options are crucial for managing depression.
• Brief psychological interventions offer a potential alternative or adjunct to pharmacotherapy.

Purpose of the Study:

• To evaluate the efficacy, feasibility, and acceptability of problem-solving treatment for major depression in primary care.
• To compare problem-solving treatment with antidepressant medication and placebo.
• To assess patient satisfaction and treatment outcomes over a 12-week period.

Main Methods:

• A randomized controlled trial involving 91 primary care patients diagnosed with major depression.
• Comparison of problem-solving treatment (six sessions over 12 weeks) against amitriptyline and placebo, all with standard clinical management.
• Assessment using observer and self-reported measures of depression severity, social outcomes, and psychological symptoms.

Main Results:

• Problem-solving treatment showed a significant difference in depression scores compared to placebo at both six and 12 weeks.
• Effectiveness of problem-solving treatment was comparable to amitriptyline, with no statistically significant difference.
• At 12 weeks, 60% of patients receiving problem-solving treatment achieved recovery, compared to 52% with amitriptyline and 27% with placebo.

Conclusions:

• Problem-solving treatment is an effective intervention for major depression in primary care.
• The treatment is feasible for delivery within a primary care setting.
• Patients found problem-solving treatment to be acceptable and helpful.