Multimodal therapy of treatment resistant depression: a study and analysis.
OBJECTIVE
To demonstrate through the use of a case study, the application of cognitive psychotherapy in the treatment of resistant depression.


METHODS
The case of a woman with an 18-month history of resistant depression associated with low self-esteem, guilt and shame, who failed to respond to three therapeutic trials of anti-depressants is described. A detailed description of a CBT intervention over 12 sessions is given.


RESULTS
Clear improvements on assessments of mood and hopelessness, along with overall improvements in social and occupational functioning were noted.


CONCLUSIONS
These improvements were attributed to a combination of CBT and pharmacotherapy, where pharmacotherapy alone failed to alleviate symptoms. A concise literature review revealed relatively few published trials of psychological treatments, and a lack of clear guidelines on pharmacological treatments. More research is needed to explore the efficacy of psychological therapies for treatment resistant depression.
Department of Psychiatry, St. John of God Hospital, Stillorgan, Ireland. bannann@eircom.net
Noreen
N
Bannan
D000328:Adult; D018687:Antidepressive Agents, Second-Generation / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003469:Culture; D003511:Cyclohexanols / Q000627:therapeutic use*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D012649:Self Concept; D012720:Severity of Illness Index; D000069470:Venlafaxine Hydrochloride
D018687:Antidepressive Agents, Second-Generation; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride