This study aimed to examine the efficacy of combining paroxetine and mirtazapine v. switching to mirtazapine, for patients with major depressive disorder (MDD) who have had an insufficient response to SSRI monotherapy (paroxetine) after the first 2 weeks of treatment.

This double-blind, randomized, placebo-controlled, three-arm study recruited participants from five hospitals in China. Eligible participants were aged 18–60 years with MDD of at least moderate severity. Participants received paroxetine during a 2-week open-label phase and patients who had not achieved early improvement were randomized to paroxetine, mirtazapine or paroxetine combined with mirtazapine for 6 weeks. The primary outcome was improvement on the Hamilton Rating Scale for Depression 17-item (HAMD-17) scores 6 weeks after randomization.

A total of 204 patients who showed early non-response to paroxetine monotherapy were randomly assigned to receive either mirtazapine and placebo (n = 68), paroxetine and placebo (n = 68) or mirtazapine and paroxetine (n = 68), with 164 patients completing the outcome assessment. At week 8, the least squares (LS) mean change of HAMD-17 scores did not significantly differ among the three groups, (12.98 points) in the mirtazapine group, (12.50 points) in the paroxetine group and (13.27 points) in the mirtazapine plus paroxetine combination group. Participants in the paroxetine monotherapy group were least likely to experience adverse effects.

After 8 weeks follow-up, paroxetine monotherapy, mirtazapine monotherapy and paroxetine/mirtazapine combination therapy were equally effective in non-improvers at 2 weeks. The results of this trial do not support a recommendation to routinely offer additional treatment or a switch in treatment strategies for MDD patients who do not show early improvement after 2 weeks of antidepressant treatment.

To determine the prevalence of high weight at different characteristics, understand the perceptions and behaviours towards high body weight, and determine potential influencing factors of body weight misperception among high-weight adults in Jilin Province.

A cross-sectional survey with complex sampling design was conducted. We described the prevalence and perception of high body weight.

Northeast China in 2012.

Adults (n 20 552) aged 18–79 years.

Of overweight individuals, 37·4 % considered themselves as ‘normal weight’, 4·8 % reported themselves as being ‘very thin’ and only 53·1 % were aware of their own weight being ‘overweight’. About 1·8 % of both male and female obese individuals perceived themselves as ‘very thin’. Only 29·1 % of obese people thought of themselves as ‘too fat’. Nearly 30·0 % of centrally obese men and women perceived that their waist circumference was about right and they were of ‘normal weight’; 5·7 % of the centrally obese even perceived themselves as being ‘very thin’. Only 51·8 and 12·5 % of centrally obese individuals reported themselves to be ‘overweight’ or ‘too fat’. Body weight misperception was more common in rural residents (OR; 95 % CI: 1·340; 1·191, 1·509). The prevalence of body weight misperception increased with age (middle age: 1·826; 1·605, 2·078; old people: 3·101; 2·648, 3·632) and declined with increased education level (junior middle school: 0·628; 0·545, 0·723; senior middle school: 0·498; 0·426, 0·583; undergraduate and above: 0·395; 0·320, 0·487).

Body weight misperception was common among adults from Jilin Province.