The effectiveness of psychological treatments for treatment-resistant depression: a systematic review.
OBJECTIVE
A systematic review of all studies (controlled and uncontrolled) to evaluate psychological interventions with treatment-resistant depression.


METHODS
A systematic search to identify studies evaluating a psychological intervention with adults with a diagnosis of major depressive disorder who had not responded to at least one course of antidepressant medication.


RESULTS
Twelve studies met inclusion criteria, of which four were controlled and eight uncontrolled. Treatment effect sizes were computable for four studies and ranged from 1.23 to 3.10 with a number of better quality studies demonstrating some improvements in patients following a psychological intervention.


CONCLUSIONS
Psychological treatments for depression are commonly delivered and often recommended following the failure of medication. The paucity of evidence for their effectiveness in these situations is a significant problem. There is a need for studies with a strong controlled design investigating the effectiveness of psychological treatments for patients with treatment-resistant depression.
McPherson
S
S
Psychotherapy Evaluation Research Unit, Tavistock Centre, London, UK. susan@mcpherson.org.uk
Cairns
P
P
Carlyle
J
J
Shapiro
D A
DA
Richardson
P
P
Taylor
D
D
D000465:Algorithms; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D005500:Follow-Up Studies; D006801:Humans; D011446:Prospective Studies; D011613:Psychotherapy; D016896:Treatment Outcome
D000928:Antidepressive Agents