Psychological treatment of depression: Results of a series of meta-analyses

2011 ◽  
Vol 65 (6) ◽  
pp. 354-364 ◽  
Author(s):  
Pim Cuijpers ◽  
Gerhard Andersson ◽  
Tara Donker ◽  
Annemieke van Straten
Author(s):  
Pim Cuijpers ◽  
Eirini Karyotaki

Abstract Perinatal depression is an important public health problem. Psychological interventions play an essential role in the treatment of depression. In the current paper, we will present the results of a series of meta-analyses on psychological treatments of perinatal depression. We report the results of a series of meta-analyses on psychological treatments of depression, including perinatal depression. The meta-analyses are based on a database of randomized trials on psychotherapies for depression that has been systematically developed and updated every year. Psychological interventions are effective in the treatment of perinatal depression with a moderate effect size of g = 0.67, corresponding with a NNT of about 4. These effects were still significant at 12 months after the start of the treatment. These interventions also have significant effects on social support, anxiety, functional impairment, parental stress, and marital stress. Possibly the effects are overestimated because of the use of waiting list control groups, the low quality of the majority of trials and publication bias. Research on psychotherapies for depression in general has shown that there are no significant differences between the major types of therapy, except for non-directive counseling that may have somewhat smaller effects. CBT can also be delivered in individual, group, telephone, and guided self-help format. Interventions in subthreshold depression are also effective and may prevent the onset of a full-blown depressive disorder, while therapies may be less effective in chronic depression. Psychological interventions are effective and deserve their place as first-line treatment of perinatal depression.


2015 ◽  
Vol 25 (4) ◽  
pp. 301-308 ◽  
Author(s):  
N. Solomonov ◽  
J. P. Barber

In the past several decades, increasing evidence supports the efficacy of psychotherapies for depression. The vast majority of findings from meta-analyses, randomized clinical trials (RCTs) and naturalistic studies have demonstrated that well-established psychotherapies (behavioural activation, problem-solving therapy, psychodynamic therapy, cognitive-behavioural therapy, interpersonal therapy and emotion-focused therapy) are superior to no-treatment and control conditions, and are in most cases equally effective in treating depression. However, despite this abundant support for psychotherapies, studies have also consistently shown high drop-out rates, high percentages of non-respondent patients who experience treatment failures, and mixed findings regarding the enduring effects of psychotherapy. Thus, there is a need to develop more personalised treatment models tailored to patients’ needs. A new integrative sequential stepwise approach to the treatment of depression is suggested.


Author(s):  
Philip Wilkinson ◽  
Ken Laidlaw

This chapter on interpersonal psychotherapy (IPT) describes the theory and practice of this structured psychological treatment. It discusses the implementation of IPT with older people. Next it reviews the applications of IPT with a main focus on the treatment of depression in older adults and distinguishes between the treatment of depression with and without cognitive impairment. It summarizes the structure of IPT and the use of specific techniques, and it then addresses the main therapeutic foci encountered in treatment (grief, interpersonal role disputes, role transitions, and interpersonal deficits). Finally, it briefly reviews the evidence base for IPT with older people.


2021 ◽  
pp. 452-458
Author(s):  
Sharon Manne

Emotion-focused therapy (EFT) is a psychological treatment that posits that exploring and understanding one’s painful emotions is necessary for adaptive functioning. EFT enhances clients’ awareness and ability to access, understand, interpret, regulate, and potentially transform their maladaptive emotional responses. This chapter describes the principles, intervention approaches, and empirical evidence evaluating EFT in both nononcology and oncology populations. There is extensive empirical evidence supporting EFT for the treatment of depression, anxiety, and traumatic life events and relationship distress among the general population. Although components of EFT, such as inner awareness and self-compassion, can be found in other psychological interventions provided to cancer patients and survivors, EFT has received little empirical attention in the psycho-oncology literature. There are only two studies that have evaluated EFT for cancer patients, and one of these studies did not support its efficacy. It may be premature to conclude whether EFT has clinical utility. Future work may benefit from a more formal test of EFT, where therapists are carefully trained and monitored to deliver EFT using the phases, steps, and approaches described in this chapter, both in the individual and couples’ context.


Author(s):  
David W. Kissane ◽  
Matthew Doolittle

The development of clinical depression is common during palliative care, adversely affects quality of life and adherence to medical treatments, yet regrettably can pass unrecognized. Screening for distress as the sixth vital sign is therefore highly recommended. Demoralization is another form of distress where the apparent pointlessness of continued life may lead to suicidal thinking. As the mental condition deteriorates, co-morbid states of anxiety, depression, and demoralization become more likely. Rates of suicide are increased with advanced cancer and poor symptom control. Fortunately, combined treatment with medication and counselling is effective in ameliorating depression, demoralization, and suicidality. Meta-analyses of psychotherapy trials confirm clear benefits, with behavioural activation, supportive, interpersonal, and cognitive behavioural therapies all making contributions. Group, couple, and family therapies optimize support for all involved. All members of the multidisciplinary team contribute to the active treatment of depression, demoralization, and the prevention of suicide.


Author(s):  
John D. Teasdale

Chapter 4 explores the relationship between cognition and emotion using the metaphor of ‘mind-in-place’. It considers three basic ideas – that we do not have one mind, but many, which vary in dominance; that mood disorders can be thought of in terms of the persistence of particular minds-in-place; and that cognitive behaviour therapies for mood disorders work by helping clients shift out of the mind-in-place in which they are stuck. The chapter also discusses the psychological treatment of depression, and cognitive therapy.


2009 ◽  
Vol 11 (3) ◽  
pp. 199-214 ◽  
Author(s):  
Allan M. Leventhal ◽  
David O. Antonuccio

Over the past 30 years psychiatry has made a paradigm shift within a medical model from a psychological to a biological explanation for mental disorder. Depression is attributed to an imbalance of monoamines in the brain caused by depletion of neurotransmitters at receptor sites. The standard of care for treating depression is prescription of antidepressant medications alleged to correct this chemical imbalance. Research results testing the chemical imbalance theories for depression have been contradictory to the theories. Analyses of data from studies and meta-analyses of the efficacy of antidepressants indicate selective publication fostering an inflated impression of effectiveness and that antidepressants offer little more than placebos. Several sources of error, particularly breaking of the blind, may have determined outcome in studies showing drug/placebo differences. Despite negative results regarding the theory and pharmacotherapy for depression, the frequency of diagnoses of depression and prescription of antidepressant drugs have increased enormously. Economic interests more than science appear to be determining the treatment of depression. Prescription of antidepressant drugs as the standard of care for depression warrants reconsideration. A biopsychosocial model may be more useful than a disease model for conceptualizing and treating depression.


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