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

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

doi:https://doi.org/10.1177/070674371305800703

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

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

Research output: Contribution to journal › Review article › Academic › peer-review

35 Citations (Scopus)

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)	386-92
Number of pages	7
Journal	Canadian journal of psychiatry. Revue canadienne de psychiatrie
Volume	58
Issue number	7
DOIs	https://doi.org/10.1177/070674371305800703
Publication status	Published - Jul 2013

Keywords

Antidepressive Agents/therapeutic use
Chronic Disease
Combined Modality Therapy/methods
Depressive Disorder, Major/drug therapy
Humans
Psychotherapy/methods
Randomized Controlled Trials as Topic/standards

Access to Document

https://doi.org/10.1177/070674371305800703

Cite this

@article{79b1d9fd8dd94cd4bc8f9c93b756ec10,

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/therapeutic use, Chronic Disease, Combined Modality Therapy/methods, Depressive Disorder, Major/drug therapy, Humans, Psychotherapy/methods, Randomized Controlled Trials as Topic/standards",

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

year = "2013",

month = jul,

doi = "https://doi.org/10.1177/070674371305800703",

language = "English",

volume = "58",

pages = "386--92",

journal = "Canadian journal of psychiatry. Revue canadienne de psychiatrie",

issn = "0706-7437",

publisher = "Canadian Psychiatric Association",

number = "7",

}

Psychotherapy, antidepressants, and their combination for chronic major depressive disorder: a systematic review. / Spijker, Jan; van Straten, Annemieke; Bockting, Claudi L H et al.
In: Canadian journal of psychiatry. Revue canadienne de psychiatrie, Vol. 58, No. 7, 07.2013, p. 386-92.

Research output: Contribution to journal › Review article › Academic › peer-review

TY - JOUR

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 L H

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/therapeutic use

KW - Chronic Disease

KW - Combined Modality Therapy/methods

KW - Depressive Disorder, Major/drug therapy

KW - Humans

KW - Psychotherapy/methods

KW - Randomized Controlled Trials as Topic/standards

U2 - https://doi.org/10.1177/070674371305800703

DO - https://doi.org/10.1177/070674371305800703

M3 - Review article

C2 - 23870720

SN - 0706-7437

VL - 58

SP - 386

EP - 392

JO - Canadian journal of psychiatry. Revue canadienne de psychiatrie

JF - Canadian journal of psychiatry. Revue canadienne de psychiatrie

IS - 7

ER -