Psychotherapy ineffective for medicated patients with severe depression

Psychotherapy for depression patients who are already on antidepressants doesn’t improve treatment outcomes with the study also adding that those patients with severe depression who were also treated with additional psychotherapy tended to be younger, more often employed, more highly educated, and have less severe initial depression than those who were treated with antidepressant medication exclusively.

Rates of clinical depression have doubled in the last 30 years, with the WHO estimating that around 322 million people suffer worldwide. This is roughly equivalent to the total populations of Germany, France, Spain, Italy and the UK combined. Around a third of severe depression sufferers don’t respond well to therapy; they are ‘treatment resistant’, meaning that clinicians need to look for ways to improve current treatments.

The new study performed in European patients with major depression (clinically known as Major Depressive Disorder, MDD) treated under real-world conditions has found that around 1 in 3 patients treated with antidepressant medication also receive psychotherapy – non-pharmacological treatment, where patients discuss their condition with a qualified doctor or therapist. Around ¾ of these patients treated with both, antidepressant medication and psychotherapy, underwent Cognitive Behavioural Therapy.

Clinicians from the European Group for the Study of Resistant Depression, based in Austria, Italy, Belgium, Germany, Greece, France, Israel, and Switzerland, studied the effects of combined treatment in 1279 severely depressed adult patients. These patients had been treated appropriately with antidepressant medication. 31.2% of those had gone on to receive additional psychotherapy. Those receiving additional psychotherapy tended to be younger, more highly educated, more often employed, and with a lower suicide risk than those treated exclusively with antidepressant medications. In addition, they experienced an earlier onset of severe depression, more migraines and asthma, and received lower daily doses of antidepressants than those treated exclusively with antidepressants. The severity of depression in each patient was measured using the Hamilton Rating Scale for Depression, and the Montgomery and Åsberg Depression Rating Scale. The researchers found that the use of additional psychotherapy did not lead to better treatment outcomes.

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