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Adjunctive Psychotherapy for Depression Studied

Findings suggest addition of psychotherapy does not increase remission over medication alone

THURSDAY, Nov. 5 (HealthDay News) -- Adjunctive psychotherapy added to antidepressant medications for patients with chronic depression did not increase the proportion of patients achieving remission, according to a study in the November issue of the Archives of General Psychiatry.

James H. Kocsis, M.D., of Weill Cornell Medical College in New York City, and colleagues treated chronically depressed patients using a two-phase treatment protocol with phase one consisting of an antidepressant medication used in accordance with a pharmacotherapy algorithm. After phase one, patients not achieving remission were randomized to 12 weeks of either continued medication and the addition of the cognitive behavioral analysis system of psychotherapy, continued medication and the addition of brief supportive psychotherapy, or optimized medication alone.

Overall, the researchers found the mean Hamilton Scale for Depression (HAM-D) scores dropped from 25.9 to 17.7 among non-responders and from 15.2 to 9.9 among partial responders. However, there was no significant difference for the three phase two treatment strategies in terms of remission (15.0 percent), partial response (22.5 percent), non-response (62.5 percent), or HAM-D score changes.

"Although 37.5 percent of the participants experienced partial response or remitted in phase two, neither form of adjunctive psychotherapy significantly improved outcomes over that of a flexible, individualized pharmacotherapy regimen alone. A longitudinal assessment of later-emerging benefits is ongoing," the authors write.

Several authors reported financial relationships with the pharmaceutical industry. All study medications were donated by pharmaceutical companies.

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