Major depressive disorder affects nearly 15 million of American adults in a given year. (Kessler, Chiu, Demler & Walters, 2005). With the impact it has on the society as well as the well-being of the individual, it must be in the interest of the healthcare to be able to provide patients with the most effective treatment method. Extensive research has been conducted on the efficacy of antidepressant medication and cognitive therapy, the two main treatment methods used for depression today. The discussion has, however, been characterized by conflicting claims, resulting in a debate over what should be used rather than us having a definite conclusion of how patients are best ...view middle of the document...
There is, however, discrepancy between the results, and in this review a closer look will be taken at more recent research and what the results suggest.
Five randomized trials conducted from the year 2000 and onwards were selected. The primary database used for searching was PsycINFO. Keywords used include “psychotherapy”, “antidepressants”, “medication”, “psychopharmaca”, “depression treatment” and “depressive disorder”. This was later narrowed down to closely fit the research question. Specific concepts in the search then included “cognitive therapy” as well as “Relapse”, “Combination Treatment”, and the name specific commonly used medications.
In research conducted by Hollon et al (2005), it was stated that while there was evidence for the enduring effects of cognitive therapy, there was a lack of extensive research comparing the effects to the use of antidepressant medication after terminating the treatment.
In the study, 180 patients meeting the criteria for severe and major depression were assigned to either one of the treatment methods. Of these, 104 met the response criteria and were included in a 12 month continuation phase and constitute the main focus of the study. Patients who had responded to the therapy were withdrawn and followed up during a 12-month period. Those who had responded to the medication treatment (Paroxetine) were either assigned to a placebo group or a continuation medication group, with both being followed up for 12 months. The Hamilton Depression Rating Scale (HDRS) was used during the entire study, and during the continuation phase relapse was defined as a return of symptoms lasting for at least 2 weeks.
The results display that patients who had been withdrawn from cognitive therapy treatment were less likely to relapse (30.8%) than those who had been withdrawn from medications (76.2%). No significant difference was found between patients withdrawn from therapy and those who were kept on medication.
The findings of the study suggest that cognitive therapy has better enduring effects than medication, and is just as effective as keeping the patients on medication.
The perhaps most highlighted study in recent years is the one of DeRubeis et al (2005), a straightforward placebo controlled trial comparing the efficacy of antidepressant medication and cognitive therapy in the treatment of moderate to severe depression. The background of the study consisted in a lack of research evaluating the effects of cognitive therapy in this specitic group.
In the study, which took place at the research clinics of the University of Pennsylvania and Vanderbilt University, 240 adult patients were assigned to either one of the two treatment groups or the placebo group. The medication used was Paroxetine. Just like in the previous study, the Hamilton Depression Rating Scale was used.
At 8 weeks, the results were measured in the treatment groups. The response rates for antidepressants (50%) and cognitive therapy...