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Latest revision as of 20:59, 29 July 2020

Clinical Depression Microchapters

Home

Patient Information

Major Depressive Disorder (Patient Information)

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Clinical Depression from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Substance/Medication-induced Depressive Disorder

Depressive Disorder due to a Medical Condition

Diagnosis

Diagnostic Criteria

History and Symptoms

Physical Examination

Laboratory Findings

Other Imaging Findings

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Treatment

Medical Therapy

Psychotherapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Psychotherapy

There are a number of psychotherapies for depression, which may be provided individually or in a group format. Psychotherapy can be delivered by a variety of mental health professionals, including psychotherapists, psychiatrists, psychologists, clinical social workers, or psychiatric nurses.

A number of other psychotherapies for depression exist. There is evidence that behavior therapy (called behavioral activation in the treatment of depression) and interpersonal therapy are effective treatments for depression. Interpersonal psychotherapy focuses on the social and interpersonal triggers that may cause depression. Behavioral therapy is based on the assumption that behaviors are learned. Some behavior analytic models trace some depressions to childhood (see child development). This type of therapy attempts to teach people to learn healthier behaviors. 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. Narrative therapy gives attention to each person's "dominant story" by means of therapeutic conversations, which also may involve exploring unhelpful ideas and how they came to prominence. Possible social and cultural influences may be explored if the client deems it helpful. Supportive therapy encourages people to discuss their problems and provides them with emotional support. The focus is on sharing information, ideas, and strategies for coping with daily life.

Cognitive behavioral therapy

The most studied form of psychotherapy for depression is cognitive therapy (also called Cognitive behavioral therapy). Several clinical trials have shown that CBT is as effective as anti-depressant medications, even among more severely depressed patients. While the precise mechanisms of change in CBT remain an active area of research, CBT is thought to work by teaching patients to learn a set of cognitive and behavioral skills, which they can employ on their own.

Earlier research initially suggested that psychotherapy, specifically cognitive-behavioral therapy, was not as effective as medication in the treatment of depression; however, recent research suggests that CBT can perform as well as anti-depressant medication in the treatment of moderate to severe depression treated on an outpatient basis.[1] With more complex and chronic forms of depression the most effective treatment is often a combination of medication and psychotherapy.[2]

Behavioral activation

Behavioral activation may have similar effectiveness as CBT, but at lower cost, according to a randomized controlled trial. [3] Behavioral activation consisted of "included identifi cation of depressed behaviours, analysis of the triggers and consequences of depressed behaviours, monitoring of activities, development of alternative goal-orientated behaviours, scheduling of activities, and development of alternative behavioural responses to rumination."

References

  1. "Outpatient Psychotherapy Groups - Cedars-Sinai". Retrieved 2013-02-14.
  2. Thase, ME (1999). "When are psychotherapy and pharmacotherapy combinations the treatment of choice for major depressive disorder?". Psychiatr Q. 70 (4): 333–346.
  3. Rhodes S, Richards DA, Ekers D, McMillan D, Byford S, Farrand PA; et al. (2014). "Cost and outcome of behavioural activation versus cognitive behaviour therapy for depression (COBRA): study protocol for a randomised controlled trial". Trials. 15: 29. doi:10.1186/1745-6215-15-29. PMC 3903024. PMID 24447460.

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