Psychosocial Treatments for Major Depressive Disorder

Abstract

Behavior therapy (BT), cognitive-behavior therapy (CBT), and interpersonal psychotherapy (IPT) have each been shown by at least two Type 1 or Type 2 randomized controlled trials, as well as by four meta-analytic reports of the literature, to be effective psychosocial interventions for patients meeting criteria for major depressive disorder (MDD). All three psychosocial treatments have yielded substantial reductions in scores on the two major depression rating scales (the Beck Depression Inventory and the Hamilton Rating Scale for Depression), significant decreases in percentage of patients meeting the criteria for MDD at posttreatment, and substantial maintenance of effects well after treatment has ended. The data for outcomes of psychosocial and pharmacological interventions for major depressive episodes suggest that the two treatment modes are equally efficacious. At least one major study lends strong support for the superior effectiveness of combined psychosocial and pharmacological treatments with severe and chronic depression. Additional recently published data suggest that psychosocial interventions may be as effective as antidepressant medications in the treatment of severely depressed patients.

When She Says “No” to Medication: Psychotherapy for Antepartum Depression

“…Based on current guidelines for the primary care population, problem-solving therapy, interpersonal psychotherapy (IPT), and cognitive-behavioral therapy (CBT) have demonstrated efficacy in the treatment of depression, with CBT and IPT reducing symptoms as efficaciously as pharmacology [40,41]. Psychotherapy is also a valuable augmentation strategy for treatment-resistant or chronic MDD, with polytherapy often superior to medication alone [42,43].…”

The case for psychological treatment centres

“…A typical finding for depression (in double blind clinical trials) is that either drugs or weekly therapy will lift about half of the treated patients out of depression within four months. After successful treatment the risk of relapse is greater for those treated with drugs, unless they keep on taking them (figure) 13 14 15. Thus the cost effectiveness of the two approaches is similar, but many people refuse drugs because of side effects and because they want to feel more in control of their emotions.…”

Treatments for Patients With Dual Diagnosis: A Review

“…There are a substantial number of studies examining treatments for depression or alcohol-related disorders separately. For example, interpersonal psychotherapy (IPT; Weissman and Markowitz, 2002) and cognitive and behavioral interventions (cognitive-behavioral therapy; CBT; Craighead et al, 1998) have demonstrated efficacy with depressive disorders; CBT, 12-step, and relapse prevention have been shown to be efficacious in the treatment of alcoholism (e.g., Finney et al, 1999;Irvin et al, 1999;Project Match Research Group, 1997, 1998. However, few studies have examined treatments for patients with depression and a comorbid alcohol-related disorder.…”

“…Disease-specific treatments have been shown to be efficacious for individuals diagnosed with substance use or other psychiatric disorders alone (e.g., Craighead et al, 1998;Finney et al, 1999;Weissman and Markowitz, 2002). While a number of theoretical models have been developed to explain the onset and maintenance of comorbidity (see Mueser et al, 1998;Verheul and van den Brink, 2005), there are still little data supporting one model over another.…”