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Am J Psychiatry 1997; 154:390-395
Copyright © 1997 by American Psychiatric Association
Double-blind comparison of sertraline, imipramine, and placebo in the treatment of dysthymia: psychosocial outcomes
JH Kocsis, S Zisook, J Davidson, R Shelton, K Yonkers, DJ Hellerstein, J Rosenbaum and U Halbreich
Department of Psychiatry, New York Hospital-Cornell Medical Center, NY, USA.
OBJECTIVE: The purpose of this study was to determine the effects of
antidepressant pharmacotherapy on mood symptoms and psychosocial outcomes
in dysthymia. METHOD: In a multicenter, double-blind, parallel- group
trial, 416 patients with a diagnosis of early-onset primary dysthymia
(DSM-III-R) of at least 5 years' duration without concurrent major
depression were randomly assigned to 12 weeks of acute-phase therapy with
sertraline, imipramine, or placebo. The psychosocial outcome measures used
in the study were the Global Assessment of Functioning Scale, the Social
Adjustment Scale, the Longitudinal Interval Follow-up Evaluation
psychosocial ratings, and the Quality of Life Enjoyment and Satisfaction
Questionnaire. RESULTS: Sertraline and imipramine were significantly better
than placebo in improving psychosocial outcomes as measured by the first
three instruments. The Quality of Life Enjoyment and Satisfaction
Questionnaire scores demonstrated significant improvements from baseline,
and both active treatments produced significantly greater improvements than
placebo. Significantly fewer patients discontinued sertraline (6.0%) than
discontinued imipramine (18.4%) because of adverse events. CONCLUSIONS:
Pharmacotherapy is an effective treatment for dysthymia in terms of
psychosocial functioning as well as depressive symptoms, even when the
dysthymia is long-standing.
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