tailieunhanh - Báo cáo y học: " Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder | Morriss et al. BMC Psychiatry 2010 10 100 http 1471-244X 10 100 BMC Psychiatry STUDY PROTOCOL Open Access Randomised controlled trial of the clinical and cost effectiveness of a specialist team for managing refractory unipolar depressive disorder Richard Morriss1 Sarah Marttunnen2 Anne Garland3 Neil Nixon3 Ruth McDonald4 Tim Sweeney3 I I o X o u- c I m p rb3 D I r p rd c fWf3 p o r I o íX f I K I Il Iz-i p J f 2 IV ỉ p l I X m r r 5 IV ỉ I V X 6 Heather Flambert Richard Fox Catherine Kaylor-Hughes Marilyn James Min Yang Abstract Background Around 40 per cent of patients with unipolar depressive disorder who are treated in secondary care mental health services do not respond to first or second line treatments for depression. Such patients have 20 times the suicide rate of the general population and treatment response becomes harder to achieve and sustain the longer they remain depressed. Despite this there are no randomised controlled trials of community based service delivery interventions delivering both algorithm based pharmacotherapy and psychotherapy for patients with chronic depressive disorder in secondary care mental health services who remain moderately or severely depressed after six months treatment. Without such trials evidence based guidelines on services for such patients cannot be derived. Methods design Single blind individually randomised controlled trial of a specialist depression disorder team psychiatrist and psychotherapist jointly assessing and providing algorithm based drug and psychological treatment versus usual secondary care treatment. We will recruit 174 patients with unipolar depressive disorder in secondary mental health services with a Hamilton Depression Rating Scale HDRS score 16 and global assessment of function GAF 60 after 6 months treatment. The primary outcome measures will be the HDRS and GAF supplemented by economic analysis incuding the EQ5 D and analysis of barriers to care implementation and the .