Psychotherapy's Effectiveness In Depression Is Demonstrated By Two Studies Using High And Low Therapy "Doses"

Adding intensive psychotherapy to drug treatment for patients hospitalized with severe depression significantly increased the rate of response, compared to a group not receiving psychotherapy, according to a new study. The contribution added by the psychotherapy component was evident early on, with acute response rates of 70 percent in those receiving both medication and psychotherapy, compared with 51 percent for those not receiving psychotherapy. Psychotherapy was associated with an even larger difference in response rates 12 months after hospitalization, with 69 percent response for the psychotherapy group but only 36 percent for the control group. A second study, examining the minimum frequency of psychotherapy needed to maintain remission in women with recurrent depression, indicates that just one session per month was enough to prevent relapse for most patients. These two studies appear in the May issue of The American Journal of Psychiatry (AJP), the official journal of the American Psychiatric Association (APA). Both studies looked at interpersonal psychotherapy (IPT), which focuses on the relationship between mood and interpersonal life events or changes in key social roles. In each of these two trials, the therapy was modified to suit the specific patient group and treatment circumstances. The study with patients hospitalized with severe depression, "An Intensive Treatment Program of Interpersonal Psychotherapy Plus Pharmacotherapy for Depressed Inpatients: Acute and Long-Term Results," is reported by Elizabeth Schramm, Ph.D., Dietrich van Calker, M.D., Ph.D., and colleagues at the University of Freiburg in Germany. The 63 patients in the experimental group received 15 individual and 8 group psychotherapy sessions, in addition to treatment with medications. A control group of 61 patients received medication plus intensive clinical management. Both groups were assessed at the end of the five-week treatment period, then again at 3 and 12 months after hospitalization. In addition to higher rates of response, the psychotherapy group had greater improvements in global and social functioning at the end of treatment and at both follow-ups. The study of maintenance treatment, "A Randomized Trial of Weekly, Twice Monthly, and Monthly Interpersonal Psychotherapy as Maintenance Treatments for Women with Recurrent Depression," is reported by Ellen Frank, Ph.D., David J. Kupfer, M.D., and colleagues at the University of Pittsburgh. The participants were 99 women whose depressive episodes had remitted after weekly interpersonal psychotherapy on an outpatient basis, or if required, psychotherapy plus an antidepressant. Patients were randomly assigned to maintenance treatment with weekly, bimonthly, or monthly psychotherapy, over the course of two years. The psychotherapy maintenance phase, however, did not include antidepressants. Among the patients who completed the study, the rates of recurrence were similar for the three therapy frequencies; however, women who required only psychotherapy to achieve remission had lower recurrence rates than those who required an antidepressant as well (26 percent versus 50 percent). The articles are discussed in an editorial by Myrna Weissman, Ph.D., of Columbia University. AJP Editor in Chief Robert Freedman, M.D., stated, "These studies provide new evidence for the usefulness of psychotherapy in the treatment of depression, both in its severe forms requiring inpatient hospitalization and in less severe forms in outpatients." The study by Schramm and colleagues was funded by grants from the German Research Society, Bonn, Germany. The study by Frank and colleagues was supported in part by grants from the National Institute of Mental Health. Additional financial disclosures appear at the end of the article. (Am J Psychiatry. 2007; 164: 415-427; 428-436). About the American Journal of Psychiatry The American Journal of Psychiatry, the official journal of the American Psychiatric Association, publishes a monthly issue with scientific articles submitted by psychiatrists and other scientists worldwide. The peer review and editing process is conducted independently of any other American Psychiatric Association components. Therefore, statements in this press release or the articles in the Journal are not official policy statements of the American Psychiatric Association. The Journal's editorial policies conform to the Uniform Requirements of the International Committee of Medical Journal Editors, of which it is a member. For further information about the Journal visit

(Author: www.ajp.psychiatryonline.org)

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