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Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.

ABSTRACT:

SUBMITTER: Van Leeuwen E

PROVIDER: S-EPMC8092632 | biostudies-literature | 2021 Apr

REPOSITORIES: biostudies-literature

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Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.

Van Leeuwen Ellen E van Driel Mieke L ML Horowitz Mark A MA Kendrick Tony T Donald Maria M De Sutter An Im AI Robertson Lindsay L Christiaens Thierry T

The Cochrane database of systematic reviews 20210415

<h4>Background</h4>Depression and anxiety are the most frequent indication for which antidepressants are prescribed. Long-term antidepressant use is driving much of the internationally observed rise in antidepressant consumption. Surveys of antidepressant users suggest that 30% to 50% of long-term antidepressant prescriptions had no evidence-based indication. Unnecessary use of antidepressants puts people at risk of adverse events. However, high-certainty evidence is lacking regarding the effect ...[more]

PMID: 33886130

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Project description:BackgroundPsychodynamic and cognitive-behavioral group therapies are frequently applied in day hospitals for the treatment of anxiety disorders and comorbid depressive or personality disorders in Poland and other Eastern European countries. Yet there is not enough evidence as to their effectiveness in this environment; this study addresses this gap. The aim of the study is to determine the effectiveness of these two kinds of day treatment care consisting of intensive, short-term group psychodynamic and cognitive-behavioral therapy, for patients with anxiety disorders and/or comorbid depressive or personality disorders. Our objectives are to: 1) show the effectiveness of each treatment in a day-care setting relative to the wait-list control group; 2) demonstrate the relative short- and long-term effectiveness of the two active treatments; 3) carry out a preliminary examination of the predictors and moderators of treatment response; 4) carry out a preliminary examination of the mediators of therapeutic change; and 5) compare the impact of both methods of treatment on the outcome of the measures used in this study.Methods/designIn this randomized controlled trial, a total of 199 patients with anxiety disorders and comorbid depressive and/or personality disorders will be assigned to one of three conditions: 1) psychodynamic group therapy; 2) cognitive-behavioral group therapy; or 3) wait-list control group. The therapy will last 12 weeks. Both treatments will be manualized (the manuals will address comorbidity). Primary outcome measures will include self-reported symptoms of anxiety, observer-rated symptoms of anxiety, global improvement, and recovery rate. Secondary outcome measures will include the number of pathological personality traits, depression, self-esteem, defense mechanisms, beliefs about self and others, interpersonal problems, object relations, parental bonding, meta-cognition, and quality of life. Measures will be taken at baseline, post-treatment, and at six months following the end of therapy.DiscussionThe rationale is to investigate how effectively anxiety disorders and/or comorbid depressive or personality disorders can be treated in a day hospital setting, typical of the Polish health care system, during a three-month treatment period.Trial registrationClinicaltrials.gov identifier NCT02126787 , registered on 28 April 2014.

Dataset Information

Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.

Publications

Approaches for discontinuation versus continuation of long-term antidepressant use for depressive and anxiety disorders in adults.

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