Clinical depression is a recurrent illness requiring treatment and often hospitalization. Nearly 50% of people who have an episode of major depression will have a recurrence within 2-3 years. Being able to prevent the recurrence of depression in people who are at risk for the disease would go a long way to alleviate the pain and suffering of patients. During the 1980’s the federal government, through the National Institutes of Health (NIH), sponsored a large clinical trial to evaluate two drugs for depression. There were 3 treatment groups. Patients received either Imipramine (Imip), Lithium (Li), or a Placebo (Pl). Researchers randomly assigned patients to one of the 3 treatment groups and followed them for 2-4 years to track any recurrences of depression. (Prien et al., Archives of General Psychiatry, 1984). VARIABLES
QUESTION
Learn by Doing
In this activity, you will investigate the first question related to the study described below.
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CONTEXT
Clinical depression is a recurrent illness requiring treatment and often hospitalization. Nearly 50% of people who have an episode of major depression will have a recurrence within 2-3 years. Being able to prevent the recurrence of depression in people who are at risk for the disease would go a long way to alleviate the pain and suffering of patients.
During the 1980’s the federal government, through the National Institutes of Health (NIH), sponsored a large clinical trial to evaluate two drugs for depression. There were 3 treatment groups. Patients received either Imipramine (Imip), Lithium (Li), or a Placebo (Pl). Researchers randomly assigned patients to one of the 3 treatment groups and followed them for 2-4 years to track any recurrences of depression.
(Prien et al., Archives of General Psychiatry, 1984).
VARIABLES
- Hospt: Which hospital the patient was from: Labeled 1, 2, 3, 5 or 6
- Treat: 0=Lithium; 1=Imipramine; 2=Placebo
- Outcome: 0=Success 1=Failure (recurrence of depression)
- Time: Number of weeks until a recurrence (if outcome=1) or until study ended (if outcome=0)
- AcuteT: How long the patient was depressed before the start of the current study, measured in days
- Age: Age in years
- Gender: 1=Female 2=Male
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ANSWER
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Preventing Recurrence of Depression: Investigating the Effects of Different Treatments – A Clinical Trial Analysis
Introduction
Clinical depression is a debilitating illness that often requires treatment and can result in recurrent episodes, leading to increased hospitalization. The National Institutes of Health (NIH) initiated a significant clinical trial during the 1980s to evaluate the efficacy of two drugs, Imipramine (Imip) and Lithium (Li), compared to a Placebo (Pl), in preventing the recurrence of depression. This essay aims to investigate the variables involved in the study, including hospital affiliation, treatment group, outcomes, time, acute depression duration, age, and gender, to understand their significance in the context of preventing depression recurrence.
Variables
Hospt: This variable identifies the hospital from which the patient was enrolled, denoted by the values 1, 2, 3, 5, or 6. Understanding the distribution of patients across different hospitals could help determine if there are any variations in treatment approaches or patient demographics that might influence the outcomes.
Treat: The treatment variable categorizes patients into three groups: Lithium (0), Imipramine (1), and Placebo (2). Analyzing the effects of each treatment on preventing depression recurrence will enable us to assess their relative effectiveness and determine the most promising approach.
Outcome: The outcome variable differentiates between success (0) and failure (1), indicating whether patients experienced a recurrence of depression during the study period. By comparing the recurrence rates among the treatment groups, we can ascertain which treatment shows the most promise in preventing depressive episodes (Hofmann et al., 2013).
Time: This variable represents the number of weeks until a recurrence (if outcome=1) or until the study’s conclusion (if outcome=0). Analyzing the time until recurrence or study completion can provide insights into the durability of treatment effects and the potential for long-term prevention of depression.
AcuteT: AcuteT measures the duration of the patient’s depressive episode in days before the start of the current study. Examining the relationship between the acute depression duration and treatment outcomes can help identify whether the duration of the initial episode influences the effectiveness of the treatments (Glassman et al., 2002).
Age: Age represents the patient’s age in years. Assessing how age correlates with treatment outcomes can help identify potential age-related factors that contribute to the recurrence of depression.
Gender: Gender distinguishes between female (1) and male (2) patients. Analyzing the influence of gender on treatment outcomes can shed light on any gender-specific differences in depression recurrence and response to treatment (Wenzel et al., 2005).
Conclusion
Understanding the factors that contribute to preventing depression recurrence is crucial for alleviating the suffering of patients. Analyzing the variables in the NIH-sponsored clinical trial from the 1980s, such as hospital affiliation, treatment group, outcomes, time, acute depression duration, age, and gender, can provide valuable insights into the effectiveness of different treatments and their impact on preventing depressive episodes. By gaining a deeper understanding of these factors, healthcare professionals can develop more tailored approaches to prevent depression recurrence and improve the overall well-being of individuals at risk for this debilitating condition.
References
Glassman, A. H., O’Connor, C. M., Califf, R. M., Swedberg, K., Schwartz, P. J., Bigger, J. T., Krishnan, K. R. R., Van Zyl, L. T., Swenson, J. R., Finkel, M. S., Landau, C., Shapiro, P. A., Pepine, C. J., Mardekian, J., & Harrison, W. (2002). Sertraline Treatment of Major Depression in Patients With Acute MI or Unstable Angina. JAMA, 288(6), 701. https://doi.org/10.1001/jama.288.6.701
Hofmann, W., Adriaanse, M. A., Vohs, K. D., & Baumeister, R. F. (2013). Dieting and the self-control of eating in everyday environments: An experience sampling study. British Journal of Health Psychology, 19(3), 523–539. https://doi.org/10.1111/bjhp.12053
Wenzel, A., Steer, R. A., & Beck, A. T. (2005). Are there any gender differences in frequency of self-reported somatic symptoms of depression? Journal of Affective Disorders, 89(1–3), 177–181. https://doi.org/10.1016/j.jad.2005.06.009
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