title: The efficacy of long-term psychodynamic psychotherapy, fluoxetine and their combination in the outpatient treatment of depression.
abstract: OBJECTIVE
  There are few randomized controlled trials examining the efficacy of long-term psychodynamic psychotherapy (LTPP) in depression treatment. LTPP was compared with fluoxetine treatment and their combination;
  
  
  METHODS
  272 depressed patients (aged 26-34, 72% with a first episode of depression) were randomized to receive LTPP (one session/week), fluoxetine treatment (20-60 mg/day) or their combination for 24 months. Beck Depression Inventory (BDI) was the outcome measure. The psychotherapy was not manualized and the treatment took place under real-life conditions in an outpatient psychiatric clinic.
  
  
  RESULTS
  Intention-to-treat analyses indicated that all the treatments were associated with significant reductions in the BDI scores (mean reduction of 18.88 BDI points). Furthermore, LTPP and combination therapy were more effective in reducing BDI scores than fluoxetine alone (22.08 and 22.04 vs. 12.53 BDI points).
  
  
  CONCLUSIONS
  LTPP, pharmacological treatment with fluoxetine and their combination are effective in reducing symptoms of patients with moderate depression. LTPP and combined treatment were more effective compared to fluoxetine alone. These findings have implications for patients with depression who may benefit from long-term psychotherapy or combined treatment, or for depressed patients who do not wish to take medications such as fluoxetine.
authors.affiliation: a Department of Psychology , Universidade Federal do Rio Grande do Sul , Porto Alegre , Brazil.
authors.forename: Andre Goettems
authors.initials: AG
authors.lastname: Bastos
authors.forename: Luciano Santos Pinto
authors.initials: LS
authors.lastname: Guimaraes
authors.forename: Clarissa Marceli
authors.initials: CM
authors.lastname: Trentini
mesh_terms: D000328:Adult; D003131:Combined Modality Therapy; D003866:Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D005473:Fluoxetine / Q000008:administration & dosage / Q000494:pharmacology*; D006801:Humans; D008297:Male; D010045:Outpatients; D064889:Psychotherapy, Psychodynamic; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D005473:Fluoxetine; D017367:Selective Serotonin Reuptake Inhibitors
keywords: depression; fluoxetine; long-term psychodynamic psychotherapy