Psychotherapy, antidepressants, and their combination for chronic major depressive disorder: a systematic review

Jan Spijker; Annemieke van Straten; Claudi Bockting; Jolanda A C Meeuwissen; Anton J L M van Balkom

doi:10.1177/070674371305800703

Psychotherapy, antidepressants, and their combination for chronic major depressive disorder: a systematic review

Jan Spijker, Annemieke van Straten, Claudi Bockting, Jolanda A C Meeuwissen, Anton J L M van Balkom

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: Recommendations for treatment of chronic major depressive disorder (cMDD) are mostly based on clinical experiences and on the literature on treatment-resistant depression (TRD) but not on a systematic review of the literature.

METHOD: We conducted a systematic review of 10 randomized controlled trials (RCTs), with 17 comparisons between antidepressants (ADs), psychotherapy, or the combination of both interventions.

RESULTS: The best evidence is for the combination of psychotherapy and ADs, and especially for the combination of the cognitive behavourial analysis system of psychotherapy and ADs. Evidence is very weak for both ADs alone and psychotherapy alone. Assessment of TRD was mostly absent in the studies.

CONCLUSION: The best treatment for cMDD is a combination of psychotherapy and ADs. However, there is a lack of well-performed RCTs in both ADs and psychotherapy and their combination for cMDD. Therefore, the conclusions are preliminary.

Original language	English
Pages (from-to)	386-392
Journal	Canadian Journal of Psychiatry
Volume	58
Issue number	7
DOIs	https://doi.org/10.1177/070674371305800703
Publication status	Published - Jul 2013
Externally published	Yes

Keywords

Antidepressive Agents
Chronic Disease
Combined Modality Therapy
Depressive Disorder, Major
Humans
Psychotherapy
Randomized Controlled Trials as Topic
chronic depression
treatment resistent depression
guidelines

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10.1177/070674371305800703

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title = "Psychotherapy, antidepressants, and their combination for chronic major depressive disorder: a systematic review",

abstract = "OBJECTIVE: Recommendations for treatment of chronic major depressive disorder (cMDD) are mostly based on clinical experiences and on the literature on treatment-resistant depression (TRD) but not on a systematic review of the literature.METHOD: We conducted a systematic review of 10 randomized controlled trials (RCTs), with 17 comparisons between antidepressants (ADs), psychotherapy, or the combination of both interventions.RESULTS: The best evidence is for the combination of psychotherapy and ADs, and especially for the combination of the cognitive behavourial analysis system of psychotherapy and ADs. Evidence is very weak for both ADs alone and psychotherapy alone. Assessment of TRD was mostly absent in the studies.CONCLUSION: The best treatment for cMDD is a combination of psychotherapy and ADs. However, there is a lack of well-performed RCTs in both ADs and psychotherapy and their combination for cMDD. Therefore, the conclusions are preliminary.",

keywords = "Antidepressive Agents, Chronic Disease, Combined Modality Therapy, Depressive Disorder, Major, Humans, Psychotherapy, Randomized Controlled Trials as Topic, chronic depression, treatment resistent depression, guidelines",

author = "Jan Spijker and {van Straten}, Annemieke and Claudi Bockting and Meeuwissen, {Jolanda A C} and {van Balkom}, {Anton J L M}",

year = "2013",

month = jul,

doi = "10.1177/070674371305800703",

language = "English",

volume = "58",

pages = "386--392",

journal = "Canadian Journal of Psychiatry",

issn = "0706-7437",

publisher = "Canadian Psychiatric Association",

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T1 - Psychotherapy, antidepressants, and their combination for chronic major depressive disorder

T2 - a systematic review

AU - Spijker, Jan

AU - van Straten, Annemieke

AU - Bockting, Claudi

AU - Meeuwissen, Jolanda A C

AU - van Balkom, Anton J L M

PY - 2013/7

Y1 - 2013/7

N2 - OBJECTIVE: Recommendations for treatment of chronic major depressive disorder (cMDD) are mostly based on clinical experiences and on the literature on treatment-resistant depression (TRD) but not on a systematic review of the literature.METHOD: We conducted a systematic review of 10 randomized controlled trials (RCTs), with 17 comparisons between antidepressants (ADs), psychotherapy, or the combination of both interventions.RESULTS: The best evidence is for the combination of psychotherapy and ADs, and especially for the combination of the cognitive behavourial analysis system of psychotherapy and ADs. Evidence is very weak for both ADs alone and psychotherapy alone. Assessment of TRD was mostly absent in the studies.CONCLUSION: The best treatment for cMDD is a combination of psychotherapy and ADs. However, there is a lack of well-performed RCTs in both ADs and psychotherapy and their combination for cMDD. Therefore, the conclusions are preliminary.

AB - OBJECTIVE: Recommendations for treatment of chronic major depressive disorder (cMDD) are mostly based on clinical experiences and on the literature on treatment-resistant depression (TRD) but not on a systematic review of the literature.METHOD: We conducted a systematic review of 10 randomized controlled trials (RCTs), with 17 comparisons between antidepressants (ADs), psychotherapy, or the combination of both interventions.RESULTS: The best evidence is for the combination of psychotherapy and ADs, and especially for the combination of the cognitive behavourial analysis system of psychotherapy and ADs. Evidence is very weak for both ADs alone and psychotherapy alone. Assessment of TRD was mostly absent in the studies.CONCLUSION: The best treatment for cMDD is a combination of psychotherapy and ADs. However, there is a lack of well-performed RCTs in both ADs and psychotherapy and their combination for cMDD. Therefore, the conclusions are preliminary.

KW - Antidepressive Agents

KW - Chronic Disease

KW - Combined Modality Therapy

KW - Depressive Disorder, Major

KW - Humans

KW - Psychotherapy

KW - Randomized Controlled Trials as Topic

KW - chronic depression

KW - treatment resistent depression

KW - guidelines

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DO - 10.1177/070674371305800703

M3 - Article

SN - 0706-7437

VL - 58

SP - 386

EP - 392

JO - Canadian Journal of Psychiatry

JF - Canadian Journal of Psychiatry

IS - 7

ER -

Psychotherapy, antidepressants, and their combination for chronic major depressive disorder: a systematic review

Abstract

Keywords

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