Psychotherapy a Powerful Tool to Fight Depression
Cognitive behavioral therapy worked as well or better than antidepressants, other care at preventing depression or relapse
Researchers broke the group roughly into thirds. The first two thirds received eight months of continuing treatment, either through additional cognitive therapy or by taking Prozac. The final third received a placebo pill.
The people who received continuing treatment had relapse rates that were half that of the placebo group -- about 18 percent for either cognitive therapy or fluoxetine, compared with 33 percent for placebo pills.
The protective effect, however, wore off after treatment ended. Two and a half years later, all three groups had similar relapse rates, although rates in the placebo group still tended to be slightly higher.
Dr. Sudeepta Varma, a clinical assistant professor of psychiatry at the NYU Langone Medical Center in New York City, said there is a higher likelihood of depression reoccurring with each episode of depression.
"For example, with individuals who have had three or more episodes, there is a 95 percent chance of reoccurrence," Varma said.
"I hate to break the bad news when my patients ask about this, but I tell them that there are some people who fall in this category who are going to need treatment indefinitely given their prior history of multiple depressive episodes and perhaps previous incomplete remission histories," she said.
The second study involved 316 teenagers who were at risk for depression because either their parents suffered from depression or they themselves showed symptoms or had prior instances.
The teens received cognitive-behavioral group therapy in eight weekly 90-minute group sessions followed by six monthly continuation sessions at sites in Boston, Nashville, Pittsburgh and Portland, Ore.
"We try to get kids to think of a range of options," Beardslee said. "State what the problem is -- let's say they can't get over a relationship and they feel persistently sad -- then try to get them to the goal by brainstorming all the possible solutions and trying some."
During a 33-month follow-up period, the kids who received the therapy had significantly fewer depressive episodes than those who were referred for usual psychiatric care.
"We wanted to see if this intervention could be delivered systematically and reliably in four different sites in the U.S., and the answer is yes," Beardslee said. "It's a step on the way to eventually disseminating the intervention widely."