The Efficacy of Drugs and Psychotherapy in the Treatment of Acute Depressive Episodes

Weissman, Myrna M.; Prusoff, Brigitte A.; Dimascio, Alberto; Neu, Carlos; Goklaney, Mahesh; Klerman, Gerald L.

doi:10.1176/ajp.1979.136.4b.555

Cited by 338 publications

(71 citation statements)

References 10 publications

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“…It is important to note that combined treatments in research and practice are not new in the history of psychotherapy. Also, from the 1960s through the 198Os, combined treatment has been actively used in clinical work (e.g., Lazarus, 1976) and evaluated in treatment outcome research (e.g., Weissman et al, 1979). The critical issue is not the historical path per se, as much as the current interest and attention accorded combined treatments.…”

Section: General Commentsmentioning

confidence: 99%

Combined and multimodal treatments in child and adolescent psychotherapy: Issues, challenges, and research directions.

Kazdin¹

1996

Clinical Psychology: Science and Practice

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Combinations of treatment are used increasingly in child and adolescent therapy research, following a pattern long evident in clinical practice. The present atticle evaluates the multiple influences leading to the use of combined treatments, different ways in which treatments are combined, and challenges that combined treatments mise for research and practice. The central thesis is that combined treatments are unlikely to contribute t o treatment outcome unless there are signiricant changes in the way research is conceptualized and conducted. Limitations in methods of combining treatment, the absence of explicit and empirically defensible decision rules for individually tailored treatments, perpetuation of cument limitations in the ways treatments are tested and delivered, and methodological obstacles for evaluating combined treatments are used t o bolster the thesis. Recommendations are made for Improving research on combined treatments, such as investigating the decision-making process guiding the combinations of treatment, the constituent techniques that are used to form combinations, novel models of delivering services t o bolster outcome, and processes and mechanlsms of therapeutic change.

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Section: General Commentsmentioning

confidence: 99%

Combined and multimodal treatments in child and adolescent psychotherapy: Issues, challenges, and research directions.

Kazdin¹

1996

Clinical Psychology: Science and Practice

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“…One study compared cognitive, behavioral, and social skills interventions (6). Psychotherapy and pharmacotherapy have also been compared (7,8).…”

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confidence: 99%

Amount of therapist contact and outcome in a multidimensional depression treatment program

Schmidt

Miller

1983

Acta Psychiatr Scand

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An 8-week multidimensional program of behavioral management, cognitive restructuring, and assertiveness training was administered to depressed outpatients either individually with a single therapist (n = 12), in two small groups (n = 11), or one large group (n = 11), or as bibliotherapy (n = 12). A randomly assigned waiting list control group was also included (n = 10). Follow-up assessments were conducted at 18 weeks. Principal findings were that 1) there were no significant pretreatment differences among groups, 2) all treated groups including bibliotherapy improved substantially over the course of treatment, 3) the waiting list control group was unchanged during this same period, 4) there were no significant differences among treated groups at termination or at follow-up, nor did these groups change significantly over the period of follow-up. Thus the effectiveness of this multidimensional program was supported, but its efficacy was not systematically influenced by amount of therapist contact.

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“…Although the combined treatment condition consistently exhibited the highest rate of full response, there were no significant differences between combination therapy and either of the two monotherapies on either the Beck Depression Inventory (BDI, Beck et al, 1961) or the Hamilton Rating Scale for Depression (HRSD, Hamilton, 1960). Unlike Weissman et al (1979 found no statistically significant difference in rates of attrition for the full sample among the three treatment modalities (x' = 3.58, ns). The investigators report that there was an indication of an advantage for combination therapy observed only in those who completed treatment (n = 64, 60%) at posttreatment as measured by a composite index of the Hamilton Rating Scale for Depression, Raskin Depression Scale, Global Assessment Scale (Endicott et al, 1976), Beck Depression Inventory, and the Minnesota Multiphasic Personality Inventory (scale for depression, Hathaway and McKinley, 1951).…”

Section: Acute Treatmentmentioning

confidence: 83%

“…She also found that these additive effects depended upon both the marital and the employment status of the woman. Aneshensel reported that while employed wives with a combination of low marital strain and low employ- Herman et al, 1974;Paykel et al, 1975Weissman et al, 1979Blackburn et al, 1981Murphy et al, 1984Beck et al, 1985Frank et al, 1990Hollon et al, 1992 ment strain were the least depressed, employed wives with high marital strain and high employment strain and nonemployed wives with high marital strain were the most depressed. A woman's ability to meet these multiple role demands and function effectively in each of them is bound to be compromised by the symptoms of a major depressive episode.…”

Section: Psychosocial Stress Following Onsetmentioning

confidence: 99%

Combination therapy and the depressed woman

Karp

Frank

1995

Depression

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While the question of the relative efficacy of combination pharmacotherapy and psychotherapy vs. either therapy alone has received some research attention within the last 25 years, the authors attempt to narrow the focus of this question by discussing the possibility that combination therapy may be of special value for women with major depression. Theoretical models explaining why combination therapy, in general, might be expected to be more effective are described. The authors then discuss reasons why combination therapy might be a particularly efficacious treatment for depressed women, including greater psychosocial stress prior to and resulting from depression and increased cognitive distortion, both of which are more associated with depression in females. Despite a reasonable theoretical rationale for the superiority of combination in comparison to either monotherapy, examination of the available literature on acute, continuation, and maintenance treatment studies generally failed to find benefits for the use of combination therapy. Similarly, examination of the literature for gender differences among patients treated with combination therapy failed to find a specific benefit of this treatment for women. Possible reasons for these findings and suggestions for future studies are discussed. Depression 3:91–98 (1995). © 1995 Wiley‐Liss, Inc.

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The Efficacy of Drugs and Psychotherapy in the Treatment of Acute Depressive Episodes

Cited by 338 publications

References 10 publications

Combined and multimodal treatments in child and adolescent psychotherapy: Issues, challenges, and research directions.

Combined and multimodal treatments in child and adolescent psychotherapy: Issues, challenges, and research directions.

Amount of therapist contact and outcome in a multidimensional depression treatment program

Combination therapy and the depressed woman

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