title: The effect of psychotherapy added to pharmacotherapy on cortisol responses in outpatients with major depressive disorder.
abstract: The present study examined the changes of depressive symptoms and salivary cortisol responses in 36 outpatients with major depression. These patients were randomly assigned to receive combination therapy (CT), consisting of antidepressants and body-mind-spirit group psychotherapy, or monotherapy (MT), consisting of antidepressants only. The results indicated that CT and MT had similar effects on reducing depressive symptoms. Nevertheless, the results revealed that cortisol levels at night appeared to have a greater reduction in CT than in MT, indicating a downward trend in CT but an upward trend in MT. Moreover, a steeper diurnal pattern of cortisol-a larger deviation in cortisol levels between 30 and 45 minutes postwaking and evening-was more likely associated with CT than MT. The findings suggest that CT produced a protective effect on outpatients with major depression, preventing the increased night salivary cortisol levels and the flatter diurnal cortisol pattern that tended to occur in MT.
authors.affiliation: Department of Psychiatry, Cardinal Tien Hospital and School of Medicine, Fu-Jen University, Taipei, Taiwan.
authors.forename: Tsung-Tsair
authors.initials: TT
authors.lastname: Yang
authors.forename: Fei-Hsiu
authors.initials: FH
authors.lastname: Hsiao
authors.forename: Kuo-Chang
authors.initials: KC
authors.lastname: Wang
authors.forename: Siu-Man
authors.initials: SM
authors.lastname: Ng
authors.forename: Rainbow T H
authors.initials: RT
authors.lastname: Ho
authors.forename: Cecilia L W
authors.initials: CL
authors.lastname: Chan
authors.forename: Yu-Ming
authors.initials: YM
authors.lastname: Lai
authors.forename: Yu-Ting
authors.initials: YT
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use*; D002940:Circadian Rhythm; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000534:rehabilitation / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D018450:Disease Progression; D005260:Female; D006760:Hospitalization; D006801:Humans; D006854:Hydrocortisone / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D011603:Psychophysiology; D011615:Psychotherapy, Group / Q000379:methods*; D012463:Saliva / Q000737:chemistry*; D012720:Severity of Illness Index; D026443:Spiritual Therapies; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000928:Antidepressive Agents; D006854:Hydrocortisone