Measurement-based care versus standard care for major depression: A randomized controlled trial with blind raters

T. Guo, Y.T. Xiang, L. Xiao, C.Q. Hu, H.F.K. Chiu, Gabor Ungvari, C.U. Correll, K.Y.C. Lai, L. Feng, Y. Geng, Y. Feng, G. Wang

    Research output: Contribution to journalArticle

    108 Citations (Scopus)


    Objective: The authors compared measurement-based care with standard treatment in major depression. Methods: Outpatients with moderate to severe major depression were consecutively randomized to 24 weeks of either measurement-based care (guideline- and rating scalebased decisions; N=61), or standard treatment (clinicians? choice decisions; N=59). Pharmacotherapy was restricted to paroxetine (20?60mg/day) or mirtazapine (15?45mg/day) in both groups. Depressive symptoms were measured with the Hamilton Depression Rating Scale (HAM-D) and the Quick InventoryofDepressiveSymptomatology? Self-Report (QIDS-SR). Time to response (a decrease of at least 50% in HAM-Dscore) and remission (a HAM-D score of 7 or less) were the primary endpoints. Outcomes were evaluated by raters blind to study protocol and treatment. Results: Significantly more patients in the measurementbased care group than in the standard treatment group achieved response (86.9% compared with 62.7%) and remission (73.8% compared with 28.8%). Similarly, time to response and remission were significantly shorter with measurement-based care (for response, 5.6 weeks compared with 11.6 weeks, and for remission, 10.2 weeks comparedwith 19.2weeks).HAM-Dscores decreasedsignificantly in both groups, but the reduction was significantly larger for the measurement-based care group (217.8 compared with 213.6). The measurement-based care group had significantlymoretreatment adjustments (44comparedwith 23) and higher antidepressant dosages from week 2 to week 24. Rates of study discontinuation, adverse effects, and concomitant medications did not differ between groups. Conclusions: The results demonstrate the feasibility and effectiveness of measurement-based care for outpatients with moderate to severe major depression, suggesting that this approach can be incorporated in the clinical care of patients with major depression.
    Original languageEnglish
    Pages (from-to)1004-1013
    JournalAmerican Journal of Psychiatry
    Issue number10
    Publication statusPublished - 2015

    Fingerprint Dive into the research topics of 'Measurement-based care versus standard care for major depression: A randomized controlled trial with blind raters'. Together they form a unique fingerprint.

    Cite this