THE EFFECTIVENESS OF ANTIDEPRESSANTS AND COGNITIVE-BEHAVIORAL THERAPYCOMBINED IN PATIENTS WITH ENDOGENOUS-DEPRESSION - RESULTS OF ANALYSESOF VARIANCE REGARDING MAIN AND SECONDARY OUTCOME CRITERIA

In a three-site study allowing for both inpatient and outpatient setti ng conditions 155 patients with endogenous depression were randomly as signed to either the combination of cognitive-behavioral therapy and a mitriptyline or to amitriptyline plus supportive treatment. Scores on the Beck Depression Inventory and the Hamilton Rating Scale for Depres sion (rated by independent blinded clinicians) served as the main outc ome criteria at posttreatment and 12 months follow-up. Depression scor es (selection criteria;included BDI and HRSD scores > 20) and other pr etreatment data characterized the sample as severely depressed with lo ng depression and previous treatment histories. All patients showed si gnificant reductions in depressive symptoms and an improvement in func tioning, but the inpatients improved significantly more than the outpa tients. MANOVA analyses at posttreatment revealed no overall differenc es of treatment effects in the main outcome criteria. For the inpatien ts self and clinically rated improvements and responder percentages we re comparable between treatments. Outpatient results favored the combi nation including cognitive-behavioral therapy. Secondary analyses reve aled setting differences and effects in subsyndromes of depressive pat hology.