COMBINING TREATMENTS FOR DEPRESSION
Psychotherapy and Antidepressants as a
Treatment for Depression
Julie E. Gollings
Florida International University
COMBINING TREATMENTS 2
Depression affects 20-30% of the population and is most commonly treated with antidepressants or psychotherapy. Mean effect sizes for changes in depression will be calculated for 100 patients (50 male and 50 female, M = 25.5 years) that will be randomly assigned to either antidepressant medication, psychotherapy or the combination of both treatments. It is proposed that by combining these two treatments, there will be a reduction in the level of depression in participants. There will be three treatment groups which will be measured by the self-report Becks Depression Inventory (BDI) and the clinician-rated measure Montgomery Ashberg Depression Rating Scale (MADRS). The evidence suggests that the psychological interventions, psychotherapy are at least as effective as the combination treatment of major depression. Some aspirational guidelines for the treatment of depression will be proposed.
COMBINED TREATMENTS 3 Psychotherapy and Antidepressants as a
Treatment for Depression A growing body of research has indicated that treating depression with antidepressants alone has a negative outcome ( e.g. Antonuccio et al., 1995; Grohl, 1995; Kirsch & Sapirstein, 1998; Knowlton, 1997; Racy, 1995). Recent research has indicated that cognitive-behavioral therapy (CBT), a branch of psychotherapy, is the best form of treatment for depression (e.g. Antonuccio et al., 1995; Grohl, 1995; Knowlton, 1997; Racy, 1995 ). Unfortunately, very little research has been conducted on the effects of combining treatments (psychotherapy and antidepressants) for depression. A study conducted by Wexler (1992) concluded that in a study of 100 patients with major depression, 29 would recover if given pharmacotherapy alone, 47 would recover if given psychotherapy alone and 47 would recover if given combined treatment (Antonuccio, 1995). Moreover, a consistent finding across studies is a higher dropout rate among those receiving medication alone, either because of side effects or because the medication was not helping. These patients are treatment failures but are not included as treatment failures in the data for their studies. Not enough research has been devoted to the combination of treatment for depression. The majority of research is based on studying the effects of psychotherapy on depression alone and the effects of medication on depression alone. Reportedly, the effects of treating depression solely with medication has a negative outcome and a high dropout rate. Researchers have used blind studies and double-blind studies for observing patients on the placebo effect and control group. There is a downfall to this type of experimental research, due to the fact that the side effects of the medication are clearly observable, so the staff along with the patients are aware of which they have received.
COMBINED TREATMENTS 4 Through research it was made clear that ordinary medical doctors (MD’s) are allowed to administer antidepressants to depressed patients without offering psychotherapy as another form of treatment. This is a problem, as noted by Buchheim (Feb., 1992 & March, 1992), physicians are actively marketed to by drug companies, given free gifts and vacations. Professionals you think you are paying to receive the best and the most thorough treatment available may be in the pocket of a pharmaceutical company. A whole host of medical doctors and psychiatrists, are prescribing whatever is new on the market and not because it is based upon medical research. Depression is conventionally viewed as a “medical illness” and drugs are the most commonly delivered treatment for depression in the United