RESUMO
BACKGROUND: The aim of our study was to evaluate the efficacy of electroconvulsive (ECT) and venlafaxine therapy from the patient's point of view. METHODS: We used a retrospective chart review from 22 inpatients who underwent ECT and 22 patients treated with venlafaxine due to resistant unipolar or bipolar depression. We used bilateral ECT in a median of 8 (IQR 7-9.7) sessions and venlafaxine therapy with a median daily dosage of 225 mg (IQR 150-225 mg) for a median of 4 (IQR 4-5) weeks. The main outcome was change in a self-evaluation scale - Short Form of the Beck Depression Inventory (BDI-SF). The response was defined as the decreasing of the BDI-SF score by >or=50%, remission as decreasing of BDI-SF score Assuntos
Antidepressivos de Segunda Geração/uso terapêutico
, Cicloexanóis/uso terapêutico
, Transtorno Depressivo/terapia
, Eletroconvulsoterapia/psicologia
, Satisfação do Paciente
, Adulto
, Transtorno Depressivo/psicologia
, Feminino
, Humanos
, Masculino
, Pessoa de Meia-Idade
, Escalas de Graduação Psiquiátrica
, Estudos Retrospectivos
, Autoavaliação (Psicologia)
, Índice de Gravidade de Doença
, Resultado do Tratamento
, Cloridrato de Venlafaxina
RESUMO
The aim of the study was to assess the 6-months treatment efficacy and 24-month follow up of three different therapeutic programs (A. moclobemide and supportive guidance, B. group cognitive-behavioral therapy and pill placebo, and C. combination of moclobemide and group cognitive-behavioral therapy) in patients with a generalized form of social phobia. Eighty one patients (38 males and 43 females) were randomly assigned to three different therapeutic programs. Patients were regularly assessed on a monthly basis by an independent rater on the LSAS (Liebowitz Social Anxiety scale), CGI (Clinical Global Impression) for severity and change and BAI (Beck Anxiety Inventory). Altogether, sixty-six patients completed the six month treatment period and 15 patients dropped out. All therapeutic groups showed significant improvement. A combination of CBT and pharmacotherapy yielded the most rapid effect. Moclobemide was superior for the reduction of the subjective general anxiety (BAI) during the first 3 months of treatment, but its influence on avoidant behavior (LSAS avoidance subscale) was less pronounced. Conversely, CBT was the best choice for reduction of avoidant behavior while a reduction of subjective general anxiety appeared later than in moclobemide. After 6 months of treatment there were best results reached in groups treated with CBT and there was no advantage of the combined treatment. The relapse rate during the 24-month follow up was significantly lower in the group treated with CBT in comparison with the group A. formerly treated with moclobemide alone.