PAROXETINE IN MAJOR DEPRESSION
2003; Elsevier BV; Volume: 42; Issue: 5 Linguagem: Inglês
10.1097/01.chi.0000046825.95464.da
ISSN1527-5418
Autores Tópico(s)Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
ResumoThe article by Keller et al., 2001 Keller MB Ryan ND Strober M et al. Efficacy of paroxetine in the treatment of adolescent major depression: a randomized, controlled trial. J Am Acad Child Adolesc Psychiatry. 2001; 40: 762-772 Abstract Full Text Full Text PDF PubMed Scopus (549) Google Scholar is one of only two to date to show a positive response to selective serotonin reuptake inhibitors (SSRIs) in child or adolescent depression. We believe that the Keller et al. study shows evidence of distorted and unbalanced reporting that seems to have evaded the scrutiny of your editorial process. The study authors designated two primary outcome measures: change from baseline in the Hamilton Rating Scale for Depression (HAM‐D) and response (set as fall in HAM‐D below 8 or by 50%). On neither of these measures did paroxetine differ significantly from placebo. Table 2 of the Keller article demonstrates that all three groups had similar changes in HAM‐D total score and that the clinical significance of any differences between them would be questionable. Nowhere is this acknowledged. Instead: 1.The definition of response is changed. As defined in the “Method” section, it has a nonsignificant p value of .11. In the “Results” section (without any explanation), the criterion for response is changed to reduction of HAM‐D to below 8 (with a p value of .02). By altering the criterion for the categorical measure of outcome, the authors are able to claim significance on a primary outcome measure. 1.In reporting efficacy results, only “response” is indicated as a primary outcome measure, and it could be misunderstood that response was the primary outcome measure. Only in the discussion is it revealed that “Paroxetine did not separate statistically from placebo for…HAM‐D total score,” without any acknowledgment that total score was one of the two primary outcome measures. The next sentence is a claim to have demonstrated efficacy for paroxetine.
Referência(s)