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For Treatment of Depression, Psychotherapy on the Decline

To maintain remission, mindfulness-based cognitive therapy, antidepressants equally successful

MONDAY, Dec. 13 (HealthDay News) -- Two studies published in the December issue of the Archives of General Psychiatry address treatment of depression, with one study finding that use of psychotherapy has significantly decreased since 1998. The other study found that, for maintenance of remission, either pharmacotherapy or mindfulness-based cognitive therapy (MBCT) should be continued.

Steven C. Marcus, Ph.D., of the University of Pennsylvania in Philadelphia, and Mark Olfson, M.D., M.P.H., of Columbia University in New York City, analyzed service utilization data from two nationally representative surveys of the U.S. household population, one from 1998 and one from 2007. The rate of outpatient depression treatment rose from 2.37 to 2.88 per 100 persons. There was only a slight change noted in the percentage of treated patients using antidepressants over this time period (73.8 percent increasing to 75.3 percent). The percentage receiving psychotherapy, however, declined from 53.6 to 43.1 percent.

In the second study, Zindel V. Segal, Ph.D., of the Centre for Addiction and Mental Health in Toronto, and colleagues studied 84 patients in remission from major depression to compare rates of relapse in those receiving MBCT and those receiving maintenance antidepressant monotherapy (M-ADM). The researchers found that MBCT provided a protection against relapse/recurrence similar to that of maintenance antidepressant pharmacotherapy, and confirmed the importance of maintaining at least one long-term active treatment in unstable remitters.

"For patients whose acute phase remission was marked by periodic symptom flurries, discontinuing M-ADM and receiving MBCT or continuing with M-ADM significantly lowered relapse/recurrence risk compared with discontinuation to placebo," Segal and colleagues conclude. "Of note, in this group of patients in need of continued intervention, MBCT and M-ADM were equally effective."

An author of the first study disclosed receiving grants from Bristol-Myers Squibb and Eli Lilly & Company.

Abstract - Marcus
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Abstract - Segal
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