Peselow ED, et al. – This study aims at examining the prophylactic effectiveness of four commonly used SSRIs in MDD in a naturalistic setting with long-term follow-up, the effect of concomitant Cognitive Behavioral Therapy (CBT), and the predictors of outcome. The preliminary data may help in defining the clinical utility of antidepressants and CBT in the prophylaxis of MDD. Methods
In a prospective cohort study, 387 patients who either remitted or responded following treatment with four different SSRIs - fluoxetine, escitalopram, sertraline and paroxetine - were followed up over several years.
During an average follow-up period of 34.5 months, 76.5% of patients experienced MDD recurrence.
Escitalopram and fluoxetine showed a numerically higher prophylactic efficacy than paroxetine and sertraline but the difference was insignificant.
Concluding limited prophylaxis effectiveness for SSRI-only treatment, with a recurrence rate of 82.0%.
Compared to 59.0% of patient recurrence rate in concomitant CBT increased prophylactic efficacy of antidepressant treatment.
The relatively small size of the CBT and the lack of randomization may undermine the extrapolation of its findings to clinical practice.
Istoric In Romania, in vremea comunismului, pshiatrii au fost incadrati in APR, ramura a celorlalte ramuri medicale.Dupa 1989 APR si-a coninuat prezenta, fiind in continuare condusa de urmasii lui Predescu, Gorgos, Angheluta & co. APR se face vinovat in fata istoriei printr-o selectie mafiotica care a coborit psihiatria romaneasca la un instrument de persecutie a regimului fata deorice aspiratie de innoire,de respingerea a numeroase valori care n-au incaput in breasla si au trebuit sa emigreze sau sa fie marginalizati, perspectiveneavind decit cei hiperadaptati la teroarea raului. Persecutiile fata de psihiatrii si chiar fata de unii bolnavi sunt cunoscute. Text integral