CONCLUSIONS This systematic review provides evidence for the efficacy of both SSRIs and TCAs in the treatment of chronic depression and showed a better acceptability of SSRIs
INTRODUCTION Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences .
This review examined the efficacy and acceptability of selective serotonin reuptake inhibitors ( SSRIs ) and tricyclic antidepressants ( TCAs ) in the treatment of chronic depression .
Additionally , the comparative effectiveness of the two types of antidepressants has been examined .
Lost human capital from early-onset chronic depression.
OBJECTIVE Chronic depression starts at an early age for many individuals and could affect their accumulation of " human capital " ( i.e. , education , higher amounts of which can broaden occupational choice and increase earnings potential ) . The authors examined the impact , by gender , of early- ( before age 22 ) versus late-onset major depressive disorder on educational attainment . They also determined whether the efficacy and sustainability of antidepressant treatments and psychosocial outcomes vary by age at onset and quantified the impact of early- versus late-onset , as well as never-occurring , major depressive disorder on expected lifetime earnings . METHOD The authors used logistic and multivariate regression methods to analyze data from a three-phase , multicenter , double-blind , r and omized trial that compared sertraline and imipramine treatment of 531 patients with chronic depression aged 30 years and older . These data were integrated with U.S. Census Bureau data on 1995 earnings by age , educational attainment , and gender . RESULTS Early-onset major depressive disorder adversely affected the educational attainment of women but not of men . No significant difference in treatment responsiveness by age at onset was observed after 12 weeks of acute treatment or , for subjects rated as having responded , after 76 weeks of maintenance treatment . A r and omly selected 21-year-old woman with early-onset major depressive disorder in 1995 could expect future annual earnings that were 12%-18 % lower than those of a r and omly selected 21-year-old woman whose onset of major depressive disorder occurred after age 21 or not at all . CONCLUSIONS Early-onset major depressive disorder causes substantial human capital loss , particularly for women . Detection and effective treatment of early-onset major depressive disorder may have substantial economic benefits
CONCLUSIONS This systematic review provides evidence for the efficacy of both SSRIs and TCAs in the treatment of chronic depression and showed a better acceptability of SSRIs
INTRODUCTION Chronic depression represents a substantial portion of depressive disorders and is associated with severe consequences .
This review examined the efficacy and acceptability of selective serotonin reuptake inhibitors ( SSRIs ) and tricyclic antidepressants ( TCAs ) in the treatment of chronic depression .
Additionally , the comparative effectiveness of the two types of antidepressants has been examined .