STAR*D
Sequenced Treatment Alternatives to Relieve Depression
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 4,041 outpatients with MDD, a sequential 4-step pharmacological strategy with CBT as a switch or augmentation option achieved cumulative remission across steps relative to each prior step.
N
4 041
Schéma
Multi-site sequenced RCT, USA
Critère
QIDS-SR remission
Pertinence
1
RésultatCumulative remission 67% over 4 steps; QIDS-SR remission by step 36.8%/30.6%/13.7%/13.0% (steps 1-4).
Rush AJ, et al. Am J Psychiatry. 2006;163(11):1905-1917. 10.1176/ajp.2006.163.11.1905
Discussion et critique
Defined the modern stepped-care model; reanalyses (Pigott 2010) have argued the headline remission was inflated by self-report.