Objective To compare the effects of cognitive-behavior therapy (CBT) and domestic paroxetine in the treatment of minor depression. Methods A therapeutic technique model for the treatment of minor depression was established. Sixty-four patients with minor depression meeting DSM-IV criteria were divided into CBT and paroxetine groups with 32 patients respectively, and were treated for six weeks. The Hamilton Depression Scale (HAMD) was used to evaluate the clinical efficacy and relapse/recrudescence rate of the two groups. Side effects of paroxetine were also recorded. Results At the end of 2 weeks, no significant difference was noted in the reduction of the HAMD score between the two groups. At the end of 6 weeks, there was little difference in thHAMD score reduction between the two groups (F=8.3,P= 0). No significant difference was found in the curative effects between the two groups (u=316.5,P=0.06).In the paroxetine group, cure rate was 20.7%, significant improvement rate was 48.3%; In the CBT group, cure rate was 10.0%, significant improvement rate was 36.7%.The relapse/recrudescence rate after six in the paroxetine group was higher than in cognitive-behavior therapy group at 6 months’ follow-up (u=106.5,P=0.04).Conclusion The clinical efficacy of cognitive-behavior therapy for minor depression seems to be similar to that of paroxetine. The established model of CBT can be used in clinical practice.
Objective To evaluate the cost effectiveness of four different mechanisms clinical commonly used antidepressants, namely, amitriptyline, escitalopram, mirtazapine and venlafaxine in the treatment of moderate-severe depressive disorder in China and to provide clinicians with some advice. Methods We carried out the cost-effectiveness analysis of four antidepressants by establishing a decision tree model. The parameters uncertainty in the model was estimated through one-way sensitivity analysis. Results In terms of average cost-effectiveness ratio (CER), amitriptyline’s was 45.24 RMB, which was the lowest. And the CERs of mirtazapine, escitalopram and venlafaxine were 273.71 RMB, 332.00 RMB and 716.58 RMB, respectively. While in terms of incremental cost-effectiveness ratio (ICER), venlafaxine was excluded as the dominated strategy. When the threshold value of willingness to pay (WTP) was less than 3 420.92 RMB, amitriptyline was the most cost-effective; when the threshold value ranges between 3 420.92 RMB and 4 200 RMB, mirtazapine was the most cost-effective; and when the threshold value was over 4 200 RMB, escitalopram was the most cost-effective. In the one-way sensitivity analysis, when we changed the four kinds of drugs costs within a certain range, the results was not changed with the change of venlafaxine’s cost but changed with the other three drugs costs. Conclusion Clinicians may choose the most cost-effective therapy according to patients’ different WTP values. We suggests that health care institutions should encourage the use of escitalopram clinically and provide subsidies for patients so as to increase the overall society benefit.