Background. A randomized controlled clinical trial compared
treatments for major
depression in primary care. Ninety-one patients were randomized to receive
problem-solving, or amitriptyline with standard clinical management, or
placebo with standard
clinical management. This paper examines the possible predictive value
of a range of
demographic clinical and personality variables in determining outcome.
Methods. To examine the interaction between treatment group
predictor variables, analyses
of co-variants were carried out for two outcome measures: the Hamilton
Scale for Depression and the Beck Depression Inventory. Predictor variables
also entered into a stepwise
forward logistic regression in which patients were categorized as recovered
Results. None of the predictor variables examined interacted
treatment to predict outcome.
Patients with a longer duration of illness, chronic social difficulties,
definite, as opposed to
probable, major depression had a poorer outcome at the end of treatment,
irrespective of treatment group.
Conclusions. The findings in this study do not enable clear
to be given as to which
patients with major depression in primary care might benefit from either
psychological or pharmacological treatment.