title: Psychotherapy alone and combined with pharmacotherapy in the treatment of depression.
abstract: BACKGROUND
  The relative efficacy of psychotherapy and combined therapy in the treatment of depression is still a matter of debate.
  
  
  OBJECTIVE
  To investigate whether combined therapy has advantages over psychotherapy alone.
  
  
  METHODS
  A 6-month randomised clinical trial compared Short Psychodynamic Supportive Psychotherapy (n=106) with combined therapy (n=85) in ambulatory patients with mild or moderate major depressive disorder diagnosed using DSM-IV criteria. Antidepressants were prescribed according to a protocol providing four successive steps in case of intolerance or inefficacy: venlafaxine, selective serotonin reuptake inhibitor, nortriptyline and nortriptyline plus lithium. Efficacy was assessed using the 17-item Hamilton Rating Scale for Depression, the Clinical Global Impression of Severity and of Improvement, and the depression sub-scale of the Symptom Checklist.
  
  
  RESULTS
  The advantages of combining antidepressants with psychotherapy were equivocal. Neither the treating clinicians nor the independent observers were able to ascertain them, but the patients experienced them clearly.
  
  
  CONCLUSIONS
  The advantages of combining antidepressants with psychotherapy are equivocal.
authors.affiliation: Department of Psychiatry, University of Amsterdam, and Depression Research Group, Mentrum Institute for Mental Health, The Netherlands.
authors.forename: Frans
authors.initials: F
authors.lastname: de Jonghe
authors.forename: Mariëlle
authors.initials: M
authors.lastname: Hendricksen
authors.forename: Gerda
authors.initials: G
authors.lastname: van Aalst
authors.forename: Simone
authors.initials: S
authors.lastname: Kool
authors.forename: Vjaap
authors.initials: V
authors.lastname: Peen
authors.forename: Rien
authors.initials: R
authors.lastname: Van
authors.forename: Ellen
authors.initials: E
authors.lastname: van den Eijnden
authors.forename: Jack
authors.initials: J
authors.lastname: Dekker
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011614:Psychotherapy, Brief; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents