One of the main unsolved problems, and one which produces divergent
results in clinical psychopharmacology, is that concerning the selection of patients and their
diagnostic definition. An automated diagnostic procedure (PDA) was set up in order to
classify each patient into one nosographic category on the basis of a cross-sectional examination
of his mental state.
Such diagnostic procedure appears particularly suitable for multicenter drug trials,
since it gives a profile and a diagnostic definition of patients, assessed by investigators from
different areas and with different cultural, and clinical backgrounds.
In a multicenter trial (sulpiride versus haloperidol) PDA offered a chance to re-examine
and analyze the characteristics of each patient and therefore to control the criteria followed
for the sample selection in the various experimental settings. The agreement between clinician
and computer diagnosis was 78.9%; this agreement rises to 85.5% if the computerlabelled
schizo-affective syndromes are considered within the schizophrenic group. Moreover,
an attempt has been made to relate psychopathological patterns to drug responses.
A multicentre trial involving six psychiatric centres was set up in order to
evaluate the antidepressant activity of a new compound, maprotiline (Ludiomil®), compared
to that of imipramine and amitriptyline.
The investigation was carried out according to a double-blind between-patient design;
the Hamilton rating scale for depression was used as the main basis for assessment.
135 hospitalized patients entered the trial, 104 presenting endogenous depression and
31 neurotic depression. The results showed that maprotiline is an effective and welltolerated
antidepressant drug, its overall activity being quantitatively of the same order as
that observed with the reference drugs. The new drug acts particularly favourably in neurotic
depression.
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