DOUBLE-BLIND COMPARISON OF SERTRALINE, IMIPRAMINE, AND PLACEBO IN THETREATMENT OF DYSTHYMIA - PSYCHOSOCIAL OUTCOMES

Objective: The purpose of this study was to determine the effects of a ntidepressant pharmacotherapy on mood symptoms and psychosocial outcom es in dysthymia. Method: In a multicenter, double-blind, parallel-grou p trial, 416 patients with a diagnosis of early-onset primary dysthymi a (DSM-III-R) of at least 5 years' duration without concurrent major d epression were randomly assigned to 12 weeks of acute-phase therapy wi th sertraline, imipramine, or placebo. The psychosocial outcome measur es used in the study were the Global Assessment of Functioning Scale, the Social Adjustment Scale, the Longitudinal Interval Follow-tip Eval uation psychosocial ratings, and the Quality of Life Enjoyment and Sat isfaction Questionnaire. Results: Sertraline and imipramine were signi ficantly better than placebo in improving psychosocial outcomes as mea sured by the first three instruments. The Quality of Life Enjoyment an d Satisfaction Questionnaire scores demonstrated significant improveme nts from baseline, and both active treatments produced significantly g reater improvements than placebo. Significantly fewer patients discont inued sertraline (6.0%) than discontinued imipramine (18.4%) because o f adverse events. Conclusions: Pharmacotherapy is an effective treatme nt for dysthymia in terms of psychosocial functioning as well as depre ssive symptoms, even when the dysthymia is long-standing.