A direct comparison of presenting characteristics of depressed outpatients from primary vs. specialty care settings: preliminary findings from the STAR*D clinical trial
A direct comparison of presenting characteristics of depressed outpatients from primary vs. specialty care settings: preliminary findings from the STAR*D clinical trial
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DOI：
10.1016/j.genhosppsych.2004.10.003
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发表时间：
2005-03-01
影响因子：
7
通讯作者：
Golden, RN
中科院分区：
文献类型：
--
作者：
Gaynes, BN;Rush, AJ;Golden, RN
目的：没有研究直接比较了在初级护理（PC）和专科护理（SC）环境中使用相同入组标准进入临床试验的患者的抑郁症临床特征。序贯治疗替代缓解抑郁症（星星 *D）的研究（http：www.star-d.org）提供了一个独特的机会，提供这种比较的患者与一个严重的抑郁症（MDD）需要treatment.Subjects和方法：我们报告的基线数据的第一个1500例患者参加了这项试验，涉及41个诊所网站（18 PC，23 SC）。广泛的入选标准要求患者具有DSM-IV诊断的非精神病性MDD，在当前发作期间没有失败的充分药物试验，并且在17项汉密尔顿抑郁量表上得分≥ 14（HAM-D-17）主要结局包括30项临床医生评定的抑郁症状量表结果：专科护理组和PC组抑郁严重程度相当（IDS-C-30=35.8; HAM-D-17=20.4）。专科护理患者报告既往自杀企图的可能性几乎是PC患者的两倍（21% vs. 12%，P
Purpose: No study has directly compared the clinical features of depression for patients entering clinical trials using identical enrollment criteria at primary care (PC) and specialty care (SC) settings. The Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study (http://www.star-d.org) provides a unique opportunity to provide this comparison for patients with a major depressive disorder (MDD) requiring treatment.Subjects and Methods: We report baseline data for the first 1500 patients enrolled in this trial involving 41 clinic sites (18 PC, 23 SC). Broadly inclusive eligibility criteria required that patients have a DSM-IV diagnosis of nonpsychotic MDD, have not failed an adequate medication trial during their current episode and score >= 14 on the 17-item Hamilton Rating Scale for Depression (HAM-D-17) Primary outcomes included the 30-item Inventory of Depressive Symptomatology-Clinician-Rated (IDS-C-30) and the HAM-D17.Results: Specialty care and PC patients had equivalent degrees of depressive severity (IDS-C-30=35.8; HAM-D-17=20.4). Specialty care patients were almost twice as likely to report a prior suicide attempt than PC patients (21% vs. 12%, P