Schulberg H C, Pilkonis P A, Houck P
Department of Psychiatry, University of Pittsburgh School of Medicine, USA.
J Consult Clin Psychol. 1998 Dec;66(6):932-8. doi: 10.1037//0022-006x.66.6.932.
The Agency for Health Care Policy and Research Depression Guideline Panel recommended pharmacotherapy as the 1st-line treatment for more severely depressed primary care patients, but research supporting its recommendation has not been conducted with this population. A post hoc analysis was conducted, therefore, with data gathered in a randomized controlled trial about the relationship between initial level of depressive severity and functional ability, treatment with nortriptyline hydrochloride (NT) or interpersonal psychotherapy (IPT), and clinical course over 8 months among primary care patients experiencing major depression. Treatment type was unrelated to clinical course among more severely depressed patients (baseline 17-item Hamilton Rating Scale for Depression [HRSD] score > or = 20). However, less severely depressed patients (baseline 17-item HRSD score < or = 19) who were prescribed NT improved significantly more rapidly during the initial 3 months of treatment than patients provided with IPT.
医疗保健政策与研究机构抑郁症指南小组建议，药物治疗是病情较重的初级保健抑郁症患者的一线治疗方法，但尚未针对该人群进行支持其建议的研究。因此，利用一项随机对照试验收集的数据，对重度抑郁症初级保健患者的抑郁严重程度初始水平与功能能力之间的关系、盐酸去甲替林（NT）治疗或人际心理治疗（IPT）以及8个月的临床病程进行了事后分析。在病情较重的患者（基线17项汉密尔顿抑郁评定量表[HRSD]评分≥20）中，治疗类型与临床病程无关。然而，在治疗的最初3个月内，接受NT治疗的病情较轻的患者（基线17项HRSD评分≤19）比接受IPT治疗的患者改善得明显更快。
