Patients access to their own records: A comparison of patients with somatisation disorder (SD) and general psychiatric outpatients (original) (raw)

European Psychiatry, 1996

Abstract

ERASMA is an extensive survey which was conducted on more than 1800 depressed patients, who underwent hospital treatment between January and June 1993. It was a naturalistic survey which aimed to explore real performances of antidepressants prescribed within the context of everyday hospital use. Design Protocol Inclusion criteria: • man or woman > 18 years old • major depressive episode according to DSM-III-R • MADRS : Score ~ 25. major depress ion. of moderate to severe intensity • patient whose condition requires hospitalisation for at least 12 days and oral antidepressant treatment • ant idepressant prescription details and any concomitant treatments are left to the discretion of the practitioner Evaluation criteria from Day 0 to Day 60: MADRS scale/COVI scale/CGI scale Overall improvement/Clinical index of assessment/Adverse events Patient self-assessment visual scale Results: MAORS scale: percentage of patients with a 50% improvement in score : it can be seen that nearly half of them achieved this level on 012. 80% on 030 and 88% on 060. At the end point. 74% of patients had improved by 50%. which is consistent with the efficacy rates usually observed with antidepressants. Apart from prov iding a substantial amount of information concerning current practice in the treatment of depression in hospitals. the survey supports many others so far carr ied out which have not demonstrate any differences in the time to onset of therapeutic effects, just at global efficacy level. between the various therapeutic classes of antidepressants currently on the market. However. a very clear synergy appears between drug treatment and hospital care. which is crucial for the depressed patient. since any delay in the provision of effective care can lead to an exacerbation or chronicity of the symptomatology. or even to suicide. Conclusion: For any furture survey of this type. it would be a good idea to attempts to make a better assessment of the importance of these non-pharmacological factors which most definitely lie in the relational dimension of care. It should therefore be possible to take into account, at least in part. the importance of relational and psychological factors. which are often. if not always. not taken into account in conventional therapeutic studies.

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