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- Main article: Clinical depression
- Depression - Clinical guidelines
- Depression - Clinical protocols
- Depression - Cognitive analytic therapy
- Depression - Cognitive Behavioral Therapy
- Human Givens treatment of depression
- Psychotherapy for depression
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Psychotherapy[]
Psychotherapy can be delivered, to individuals or groups, by mental health professionals, including psychotherapists, psychiatrists, psychologists, clinical social workers, counselors, and psychiatric nurses. With more complex and chronic forms of depression, the most effective treatment is often considered to be a combination of medication and psychotherapy.[1] In people under 18, medication is usually offered only in conjunction with psychotherapy, not as a first line treatment.[2] Psychotherapy has been shown to be effective in older people. [3][4] Successful psychotherapy appears to prevent the recurrence of depression even after it has been terminated or replaced by occasional booster sessions. The same degree of prevention can be achieved by continuing antidepressant treatment.[5]
The most studied form of psychotherapy for depression is cognitive behavioral therapy (CBT), thought to work by teaching clients to learn a set of useful cognitive and behavioral skills. Earlier research suggested that cognitive-behavioral therapy was not as effective as antidepressant medication; however, more recent research suggests that it can perform as well as antidepressants in patients with moderate to severe depression.[6] Overall, systematic review reveals CBT to be an effective treatment in depressed adolescents,[7] although possibly not for severe episodes.[8] Combining fluoxetine with CBT appeared to bring no additional benefit[9][10] or, at the most, only marginal benefit.[11]
A review of studies on the effectiveness of Mindfulness-based Cognitive Therapy (MBCT), a recently developed class-based program designed to prevent relapse, suggests that MBCT may have an additive effect when provided with the usual care in patients who have had three or more depressive episodes, although the usual care did not include antidepressant treatment or any psychotherapy, and the improvement observed may have reflected non-specific or placebo effects.[12]
Interpersonal psychotherapy focuses on the social and interpersonal triggers that may cause depression. There is evidence that it is an effective treatment. Here, the therapy takes a structured course with a set number of weekly sessions (often 12) as in the case of CBT, however the focus is on relationships with others. Therapy can be used to help a person develop or improve interpersonal skills in order to allow him or her to communicate more effectively and reduce stress.[13]
Psychoanalysis, a school of thought founded by Sigmund Freud that emphasizes the resolution of unconscious mental conflicts,[14] is used by its practitioners to treat clients presenting with major depression.[15] A more widely practiced, eclectic technique, called psychodynamic psychotherapy, is loosely based on psychoanalysis and has an additional social and interpersonal focus.[16] In a meta-analysis of three controlled trials of Short Psychodynamic Supportive Psychotherapy, this modification was found to be as effective as medication for mild to moderate depression.[17]
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- ↑ Thase, ME (1999). When are psychotherapy and pharmacotherapy combinations the treatment of choice for major depressive disorder?. Psychiatric Quarterly 70 (4): 333–46.
- ↑ NICE (2005). NICE guidelines: Depression in children and adolescents, p. 5, London: NICE. URL accessed 2008-08-16.
- ↑ Wilson KC, Mottram PG, Vassilas CA (January 2008). Psychotherapeutic treatments for older depressed people. Cochrane Database of Systematic Reviews 23 (1): CD004853.
- ↑ Cuijpers P, van Straten A, Smit F (December 2006). Psychological treatment of late-life depression: a meta-analysis of randomized controlled trials. International Journal of Geriatric Psychiatry 21 (12): 1139–49.
- ↑ Cite error: Invalid
<ref>tag; no text was provided for refs namedpmid18199864 - ↑ Roth, Anthony; Fonagy, Peter [1996] (2005). What Works for Whom? Second Edition: A Critical Review of Psychotherapy Research, p. 78, Guilford Press.
- ↑ Reinecke MA, Ryan NE, DuBois DL (1997). Cognitive-behavioral therapy of depression and depressive symptoms during adolescence: A review and meta-analysis. Journal of the American Academy of Child and Adolescent Psychiatry 37 (1): 26–34.
- ↑ Harrington R, Whittaker J, Shoebridge P, Campbell F (May 1998). Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder. British Medical Journal 325 (7358): 229–30.
- ↑ Goodyer I, Dubicka B, Wilkinson P, et al. (July 2007). Selective serotonin reuptake inhibitors (SSRIs) and routine specialist care with and without cognitive behaviour therapy in adolescents with major depression: Randomised controlled trial. British Medical Journal 335 (7611): 142.
- ↑ Goodyer IM, Dubicka B, Wilkinson P, et al. (May 2008). A randomised controlled trial of cognitive behaviour therapy in adolescents with major depression treated by selective serotonin reuptake inhibitors. The ADAPT trial. Health Technology Assessment 12 (14): 1–80.
- ↑ Domino ME, Burns BJ, Silva SG, et al. (May 2008). Cost-effectiveness of treatments for adolescent depression: Results from TADS. American Journal of Psychiatry 165 (5): 588–96.
- ↑ Coelho HF, Canter PH, Ernst E (December 2007). Mindfulness-based cognitive therapy: Evaluating current evidence and informing future research. Journal of Consulting and Clinical Psychology 75 (6): 1000–05.
- ↑ Weissman MM, Markowitz JC, Klerman GL (2000). Comprehensive Guide to Interpersonal Psychotherapy, New York: Basic Books.
- ↑ Dworetzky J (1997). Psychology, 602, Pacific Grove, CA, USA: Brooks/Cole Pub. Co.
- ↑ Doidge N, Simon B, Lancee WJ, et al. (2002). Psychoanalytic patients in the US, Canada, and Australia: II. A DSM-III-R validation study. Journal of the American Psychoanalytic Association 50 (2): 615–27.
- ↑ Durand VM, Barlow D (1999). Abnormal psychology: An integrative approach, Pacific Grove, CA, USA: Brooks/Cole Pub. Co.
- ↑ de Maat S, Dekker J, Schoevers R, et al. (June 2007). Short Psychodynamic Supportive Psychotherapy, antidepressants, and their combination in the treatment of major depression: A mega-analysis based on three Randomized Clinical Trials. Depression and Anxiety 25: 565.