Transcript Psychotherapies in Treatment of Depression

Psychotherapies in
Treatment of Depression
Copyright © 2011. World Psychiatric Association
Evidence From Controlled Trials
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CBT in acute depression
CBT in relapse prevention
IPT in acute depression
IPT in relapse prevention
Marital therapy in marital problems
Family therapy
Group therapy
Strong
Strong
Strong
Limited
Moderate
Some
Limited
Combination with antidepressants is usually preferable and beneficial, without
impairing effects
Copyright © 2011. World Psychiatric Association
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Indications For CBT
Acute Treatment:
• Where patient prefers.
• In mild depression, may be used alone.
• In moderate depression, combine with antidepressants.
• In severe, not beneficial.
In Relapse Prevention:
• Where vulnerability to relapse or recurrence, e.g. residual symptoms not
responding to antidepressant, history of relapses, recurrences, symptom
return as drug withdrawn.
• Use as adjunct to continuation /maintenance antidepressant.
• Preferably start while during improvement while still some symptoms, so
negative cognitions accessible
Copyright © 2011. World Psychiatric Association
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Indications for Other Psychotherapies
IPT:
• In acute treatment, similar to indications for CBT
• Also where interpersonal problems prominent, combined with antidepressant.
Marital Therapy, Family Therapy:
• Where marital or family problems, during depression or after improvement.
• Combine with antidepressant
Copyright © 2011. World Psychiatric Association
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