Acute Effectiveness of Additional Drugs to the Standard Treatment of Depression

Background. The purpose of the study was to examine whether the addition of a brief individual self-help package to standard primary-care treatment of depression with antidepressants is associated with any additional improvements in clinical outcome.Method. Individuals with major depressive disorder who were prescribed an antidepressant were recruited through their general practitioner (GP) and allocated randomly to standard treatment alone or standard treatment plus self-help. Assessments of symptoms, social adjustment, global functioning, satisfaction with treatment and knowledge about the management of the disorder were completed at three time points over 26 weeks.Results. One hundred and twelve individuals agreed to participate and 96 met criteria for inclusion in the randomized controlled trial. Subjects in both treatment conditions improved substantially over the study period; the mean Beck Depression Inventory (BDI) score fell from 27·3 to 13·9 in the intention-to-treat analysis. There were no between group differences in outcome on any of the primary outcome measures, nor did these approach even marginal significance. Patients and GPs were highly satisfied with the self-help programme, and the intervention as compared to the control group reported significantly greater improvements in knowledge about depression and satisfaction with information received about depression.Conclusions. An individualized self-help package improved perceived knowledge about depression but did not have identifiable effects on outcome when offered to patients treated in primary care. The study was sufficiently well powered to detect relatively small effects.

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Tablets or Talk? A Critical Review of the Literature Comparing Antidepressants and Counseling for Treatment of Depression

Journal of Mental Health Counseling ◽

10.17744/mehc.32.2.al84578m4137768k ◽

2010 ◽

Vol 32 (2) ◽

pp. 102-124 ◽

Cited By ~ 1

Author(s):

Brad Hagen ◽

Gina Wong-Wylie ◽

Em Pijl-Zieber

Keyword(s):

Critical Review ◽

Research Evidence ◽

Standard Treatment ◽

Large Body ◽

Review Of The Literature ◽

Health Counseling ◽

Superior Efficacy ◽

Treatment Of Depression ◽

Methodological Problems ◽

Comparative Safety

Antidepressants re generally considered to be the standard treatment for depression, despite a large body of research evidence documenting the equal or superior efficacy of counseling. This article provides a critical review of the literature comparing the efficacy of antidepressants and counseling for adults with depression. Highlighted are several issues that must be considered when reviewing the literature, including methodological problems, the placebo effect, trauma and depression, comparative safety profiles, and the marketing of antidepressants. Implications for mental health counseling practice and research, including the suggestion that counseling alone should be the first treatment of choice for most persons with depression, are discussed.

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