Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacity (CREATE) Study Delivers Surprising Results
Jan 25, 2007 - 8:51:35 PM
, Reviewed by: Dr. Himanshu Tyagi
|
|
|
“We had expected to find that psychotherapy would have a positive effect. After validation and careful analysis of the data, we could see that psychotherapy was no better than regular clinical control visits in improving depressive symptoms in these patients, but that citalopram, an SSRI antidepressant, was significantly more beneficial than placebo.”
|
|
Level of Evidence
|
|
1b - Individual Randomised Control Trial
|
|
|
Key Points of this article
|
|
The study followed 284 coronary heart disease patients who also met the diagnostic criteria for major depression.
|
|
All subjects met weekly with a health care professional for an assessment of their condition.
|
|
Half were chosen at random to receive the SSRI antidepressant citalopram, and half received a placebo.
|
|
Half of the patients in each of these two groups were also selected at random to take part in to interpersonal psychotherapy, with the others having only the weekly control visits.
|
|
|
|
|
Main results
|
|
The results demonstrate the effectiveness of antidepressants, while showing that psychotherapy has little benefit for depressed heart patients.
|
|
By Université de Montréal,
[RxPG] Nearly twenty percent of cardiac patients suffer from major depression, which may have a significant negative impact on the outcome of the cardiac disease. A Canada-wide study directed by Dr. François Lespérance, professor of psychiatry at the Université de Montréal and head of the Department of Psychiatry at the Centre hospitalier de l’Université de Montréal (CHUM) is the first to assess the value of two treatments available to these patients: SSRI antidepressants and interpersonal psychotherapy. The results, to be published tomorrow in the Journal of the American Medical Association, demonstrate the effectiveness of antidepressants, while showing that psychotherapy has little benefit for depressed heart patients.
“Initially, our results seemed surprising and even disappointing,” Dr. Lespérance reports. “We had expected to find that psychotherapy would have a positive effect. After validation and careful analysis of the data, we could see that psychotherapy was no better than regular clinical control visits in improving depressive symptoms in these patients, but that citalopram, an SSRI antidepressant, was significantly more beneficial than placebo.”
The study’s co-author, Nancy Frasure-Smith, a professor in McGill University’s Department of Psychiatry and researcher at the CHUM and the Montreal Heart Institute, notes that the innovative study is one of the first to evaluate the treatment of major depression in patients with a physical illness. “There have been few studies on how to treat such patients, yet it is clear that physical and mental health influence each other.”
The study, entitled CREATE (Canadian Cardiac Randomized Evaluation of Antidepressant and Psychotherapy Efficacity) was funded by the Canadian Institutes of Health Research (CIHR), an independent public agency of the Canadian government, and by the CHUM and Montreal Heart Institute foundations. The study followed 284 coronary heart disease patients who also met the diagnostic criteria for major depression.
All subjects met weekly with a health care professional for an assessment of their condition. Half were chosen at random to receive the SSRI antidepressant citalopram, and half received a placebo. Half of the patients in each of these two groups were also selected at random to take part in to interpersonal psychotherapy, with the others having only the weekly control visits. The psychotherapy sessions were given by psychologists, social workers, and occupational therapists specially trained in interpersonal psychotherapy.
“Regular follow-up by a health care professional had a positive impact on the participants’ condition,” Dr. Lespérance concludes. “In fact, the twenty-minute follow-up visits proved to be just as beneficial as the psychotherapy sessions or even more so.”
“The results of Dr. Lesperance’s team demonstrate the importance of studying mental health problems for people afflicted with a physical disease, ” explains Dr. Rémi Quirion, scientific director of the CIHR Institute of Neurosciences, Mental Health and Addiction. “This project illustrates the importance of adequately funding health research and more specifically research into mental health.”
| Funding information and declaration of competing interests:
The study was funded by the Canadian Institutes of Health Research (CIHR), an independent public agency of the Canadian government, and by the CHUM and Montreal Heart Institute foundations.
|
Advertise in this space for $10 per month.
Contact us today.
|
 |
|
Subscribe to Psychotherapy Newsletter
|
|
|
|
About Dr. Himanshu Tyagi
|
This news story has been reviewed by Dr. Himanshu Tyagi before its publication on RxPG News website. Dr. Himanshu Tyagi, MBBS is the founder editor and manager for RxPG News. In this position he is responsible for content development and overall website and editorial management functions. His areas of special interest are psychological therapies and evidence based journalism.
RxPG News is committed to promotion and implementation of Evidence Based Medical Journalism in all channels of mass media including internet.
|
|
Additional information about the news article
|
Participating hospital centres were: the Montreal Heart Institute and Hôpital du Sacré-Cœur, Montreal; St. Michael’s Hospital and the University Health Network, Toronto; Kingston General Hospital and Hotel Dieu Hospital, Kingston; the University of Ottawa Heart Institute and Royal Ottawa Mental Health Centre, Ottawa; Capital District Health Authority, Halifax; and the Peter Lougheed Centre, Calgary Health Region, Calgary.
About The Canadian Institutes of Health Research
The Canadian Institutes of Health Research (CIHR) is the Government of Canada's agency for health research. CIHR's mission is to create new scientific knowledge and to catalyze its translation into improved health, more effective health services and products, and a strengthened Canadian health care system. Composed of 13 Institutes, CIHR provides leadership and support to more than 10,000 health researchers and trainees across Canada. www.cihr-irsc.gc.ca
Deeply rooted in Montreal and dedicated to its international mission, the Université de Montréal is one of the top universities in the French-speaking world. Founded in 1878, the Université de Montréal today has 13 faculties and together with its two affiliated schools, HEC Montréal and École Polytechnique, constitutes the largest centre of higher education and research in Québec, the second largest in Canada, and one of the major centres in North America. It brings together 2,400 professors and researchers, accommodates more than 55,000 students, offers some 650 programs at all academic levels, and awards about 3,000 masters and doctorate diplomas each year. www.umontreal.ca
|
|
Feedback
|
For any corrections of factual information, to contact the editors or to send
any medical news or health news press releases, use
feedback form
|
Top of Page
|
