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Treatment as usual (TAU) for depression: A comparison of psychotherapy, pharmacotherapy, and combined treatment at a large academic medical center

机译：抑郁症的常规治疗（TAU）：大型学术医疗中心的心理治疗，药物治疗和综合治疗的比较

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Depression is among the most prevalent and burdensome psychiatric disorders in the United States (Kessler et al., Achieves of General Psychiatry 62:617-627, 2005). There is substantial empirical support regarding efficacy of pharmacotherapy, psychotherapy, and combined treatment (both pharmacotherapy and psychotherapy) for treating depression. However, far less is known about the effectiveness of these treatments for real-world patients treated within routine clinical care settings (Cahill et al., The British Journal of Clinical Psychology 49:421-453, 2010). This study seeks to explore the effectiveness of treatment as usual (TAU) for depression in a large cohort of psychiatric outpatients receiving psychotherapy, pharmacotherapy, or combined treatment within an academic medical center. Initial and follow-up self-report assessments were analyzed for 1,322 patients receiving treatment for depression. Using these data, we determined treatment effect sizes, rates of reliable improvement (and deterioration), and rates of clinically significant improvement for psychotherapy, pharmacotherapy, and combined care. On average, all treatments produced significant improvement with effect sizes surpassing our notreatment benchmark. No significant between-group (treatment) differences in self-report outcomes were found. The rates of reliable change were similar for all treatment groups consistent with past research. The present findings support the effectiveness of psychotherapy, pharmacotherapy, and combined treatment as routinely provided within a large academic medical center for the treatment of real-world patients suffering with depression. ? 2013 American Psychological Association.
机译：抑郁症是美国最普遍和负担最重的精神疾病之一（Kessler等，Achieves of General Psychiatry 62：617-627，2005）。关于药物疗法，心理疗法以及联合治疗（药物疗法和心理疗法）治疗抑郁症的功效，有大量的经验支持。然而，对于在常规临床护理环境中接受治疗的现实世界患者的这些治疗的有效性知之甚少（Cahill等人，《英国临床心理学杂志》 49：421-453，2010）。这项研究旨在探讨在学术医学中心接受心理治疗，药物治疗或综合治疗的大量精神科门诊患者中，照常治疗（TAU）对抑郁症的有效性。对接受抑郁症治疗的1,322例患者的初次和随访自我报告评估进行了分析。使用这些数据，我们确定了心理疗法，药物疗法和综合护理的治疗效果大小，可靠改善（和恶化）的比率以及临床上显着改善的比率。平均而言，所有治疗均产生了显着改善，效果大小超过了我们的无治疗基准。没有发现自我报告结果的组间（治疗）显着差异。与过去的研究一致，所有治疗组的可靠变化率相似。本研究结果支持心理疗法，药物疗法和联合治疗的有效性，这是大型学术医学中心常规提供的，用于治疗现实世界中患有抑郁症的患者。 ？ 2013美国心理学会。

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