TY - JOUR
T1 - Effects of race and ethnicity on depression treatment outcomes
T2 - The CO-MED trial
AU - Lesser, Ira M.
AU - Khan, Ahsan
AU - Zisook, Sidney
AU - McGrath, Patrick
AU - Gaynes, Bradley N.
AU - Warden, Diane
AU - Wisniewski, Stephen R.
AU - Rush, A. John
AU - Luther, James F.
AU - Trivedi, Madhukar
AU - Fava, Maurizio
PY - 2011/10
Y1 - 2011/10
N2 - Objective: The investigators examined whether outcomes differ by race-ethnicity for patients with major depressive disorder in acute- (12 weeks) and continuation-phase (weeks 12-28) treatment with one of two antidepressant combinations or one selective serotonin reuptake inhibitor. Methods: This single-blind, seven-month prospective, randomized trial enrolled 352 non-Hispanic white (59%), 169 black (28%), and 79 white Hispanic (13%) participants from six primary and nine psychiatric care U.S. sites. Patients had nonpsychotic chronic or recurrent major depressive disorder (or both) of at least moderate severity. Escitalopram plus placebo, bupropion sustained-release plus escitalopram, or venlafaxine extended-release plus mirtazapine were delivered according to measurementbased care. The primary outcome was remission (last two consecutive 16-item Quick Inventory of Depressive Symptomatology-Self- Report ratings <8 and <6); secondary outcomes included side effects, adverse events, quality of life, function, and attrition. Results: Black participants had greater baseline psychiatric and medical comorbidity. Baseline depression severity did not significantly differ between groups. In both phases more blacks than those in other groups exited the trial early. There were only minor differences in side effects, no significant differences in remission rates, and no significant differences between groups in other outcomes for each treatment. Conclusions: Despite differences in sociodemographic characteristics and comorbidities, when measurement-based care was used, members of different minority groups had similar outcomes when treated with one antidepressant or a combination of two antidepressants. Black participants had the highest attrition rate, an important issue to address in clinical care.
AB - Objective: The investigators examined whether outcomes differ by race-ethnicity for patients with major depressive disorder in acute- (12 weeks) and continuation-phase (weeks 12-28) treatment with one of two antidepressant combinations or one selective serotonin reuptake inhibitor. Methods: This single-blind, seven-month prospective, randomized trial enrolled 352 non-Hispanic white (59%), 169 black (28%), and 79 white Hispanic (13%) participants from six primary and nine psychiatric care U.S. sites. Patients had nonpsychotic chronic or recurrent major depressive disorder (or both) of at least moderate severity. Escitalopram plus placebo, bupropion sustained-release plus escitalopram, or venlafaxine extended-release plus mirtazapine were delivered according to measurementbased care. The primary outcome was remission (last two consecutive 16-item Quick Inventory of Depressive Symptomatology-Self- Report ratings <8 and <6); secondary outcomes included side effects, adverse events, quality of life, function, and attrition. Results: Black participants had greater baseline psychiatric and medical comorbidity. Baseline depression severity did not significantly differ between groups. In both phases more blacks than those in other groups exited the trial early. There were only minor differences in side effects, no significant differences in remission rates, and no significant differences between groups in other outcomes for each treatment. Conclusions: Despite differences in sociodemographic characteristics and comorbidities, when measurement-based care was used, members of different minority groups had similar outcomes when treated with one antidepressant or a combination of two antidepressants. Black participants had the highest attrition rate, an important issue to address in clinical care.
UR - http://www.scopus.com/inward/record.url?scp=80054857547&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=80054857547&partnerID=8YFLogxK
U2 - 10.1176/ps.62.10.pss6210_1167
DO - 10.1176/ps.62.10.pss6210_1167
M3 - Article
C2 - 21969643
AN - SCOPUS:80054857547
SN - 1075-2730
VL - 62
SP - 1167
EP - 1179
JO - Psychiatric Services
JF - Psychiatric Services
IS - 10
ER -