Journal article
Predictors of nonresponse to treatment in primary care patients with dysthymia
General hospital psychiatry, v 24(1), pp 20-27
2002
PMID: 11814530
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Dysthymia is one of the most prevalent problems in primary care, especially in the elderly. In this study, we evaluated the demographic and clinical predictors of nonresponse to treatment in primary care patients with dysthymia. The study sample consisted of 338 primary care patients meeting DSMIII-R criteria for dysthymia from 4 diverse geographic sites in a randomized controlled 11-week trial of paroxetine, problem-solving therapy or placebo. Patients who attended at least 4 treatment sessions were used in the analysis. A score of less than 7 on the Hamilton was defined as a positive response to treatment. By Week 11, 52.2% of patients had a positive response to treatment. Patients with lower levels of education (odds ratio 0.44, 95% CI 0.23, 0.86), higher scores on the personality dimension of neuroticism (odds ratio 0.58, 95% CI 0.36, 0.92) and those with more severe medical illness (odds ratio 0.97, 95% CI 0.95, 0.99) were less likely to recover with either active or placebo treatments. Elderly women (>60 years of age; odds ratio 0.19, 95% CI 0.05, 0.66) were also less likely to respond to all treatments; however, females had a significantly higher response to placebo treatment compared to males. The factors associated with lack of response to treatment included lower-levels of education, high neuroticism, more severe medical illness and being an older female. This analysis is based on patients agreeing to participate in a randomized controlled trial, limiting representativeness of the sample, however, the demographic and clinical characteristics are common in elderly depressed primary care patients, and may signal the need for increased mental health specialty consultation.
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Details
- Title
- Predictors of nonresponse to treatment in primary care patients with dysthymia
- Creators
- Wayne Katon - University of WashingtonJoan Russo - University of WashingtonEllen Frank - University of PittsburghJames Barrett - Department of Community and Family Medicine, Dartmouth Medical School, Hanover, NH, USAJohn W. Williams - The University of Texas Health Science Center at San AntonioThomas Oxman - Department of Psychiatry, Dartmouth Medical School, Hanover, NH, USAMark Sullivan - University of WashingtonJohn Cornell - The University of Texas Health Science Center at San Antonio
- Publication Details
- General hospital psychiatry, v 24(1), pp 20-27
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000173695400004
- Scopus ID
- 2-s2.0-0036157591
- Other Identifier
- 991020836455404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Psychiatry