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Psychotherapies that have been recommended for the treatment of depression include cognitive behavioural therapy (CBT), (21) interpersonal psychotherapy, (26) and problem-solving therapy. (27) Among these, CBT is considered as the first-line and most evidence-based psychological therapy for depression.

Full Answer

What is the best approach to treat depression?

Cognitive behavioral therapy (CBT) and interpersonal therapy are the psychotherapeutic approaches that have the best documented efficacy in the literature for management of depression. When psychodynamic psychotherapy is used as specific treatment, in addition to symptom relief it is frequently with broader long term goals.

Which subtype of depression is best treated with antipsychotics?

Depression with psychotic features was the subtype receiving most consistent recommendations across the CPGs. Four CPGs recommended antipsychotic agents in combination with antidepressants for the treatment of depression with psychotic features [ 22, 23, 25, 26 ].

What are the treatment options for major depressive disorder (PD)?

All CPGs included serotonin selective reuptake inhibitors (SSRIs) as first-line treatment; however, one CPG also included agomelatine, milnacipran, and mianserin as first-line alternatives. Recommendations for depression subtypes (catatonic, atypical, melancholic) were included in three CPGs.

Are there affordable drugs for depression?

The vast majority of drugs used to treat depression are available in generic form, making them much more affordable than brand-name medication. Insurance coverage might also vary depending on the drug, which can greatly affect the cost of treatment. Length of treatment.

What is considered the most effective treatment for depression?

Medications and psychotherapy are effective for most people with depression. Your primary care doctor or psychiatrist can prescribe medications to relieve symptoms. However, many people with depression also benefit from seeing a psychiatrist, psychologist or other mental health professional.

What are the most effective ways to treat depression research paper?

Psychotherapy, or talk therapy, is another effective and common choice. 1 It is especially efficacious when combined with antidepressant therapy.

What are two forms of treatment for depression that have been successful?

In addition to ADM, other treatments are effective in alleviating depression. These include cognitive therapy (CT) and other forms of psychotherapy, such as interpersonal therapy,8 electroconvulsive therapy9 and electrical stimulation of the vagus nerve.

What is the gold standard treatment for depression?

Use of antidepressants is the gold standard therapy for major depression. However, despite the large number of commercially available antidepressant drugs there are several differences among them in efficacy, tolerability, and cost-effectiveness.

What type of therapy is used for depression?

Cognitive Behavioral Therapy (CBT) Cognitive behavioral therapy, or CBT, helps an individual identify and change negative thoughts and associated behaviors. People who suffer from depression often struggle with negative thought patterns. These thought patterns can influence our behavior.

What is the first line treatment for depression?

People with severe major depression usually need to be seen by a psychiatrist and sometimes need to be hospitalized. Choosing an antidepressant — For the initial treatment of severe depression, we use serotonin-norepinephrine reuptake inhibitors (SNRIs) or selective serotonin reuptake inhibitors (SSRIs).

What is better antidepressants or therapy?

For anxiety disorders, cognitive-behavioral therapy, antidepressant medications and anti-anxiety medications have all been shown to be helpful. Research generally shows that psychotherapy is more effective than medications, and that adding medications does not significantly improve outcomes from psychotherapy alone.

Why is CBT better than drug therapy?

Among different types of talk therapy examined — including CBT, self-help, mindfulness and psychodynamic psychotherapy — CBT was found to be the most effective, the researcher reported in The Lancet Psychiatry. In addition, it has fewer side effects compared to pharmacotherapy.

Why are antidepressants better than therapy?

A recent individual patient data meta‐analysis showed that antidepressant medication is slightly more efficacious than cognitive behavioral therapy (CBT) in reducing overall depression severity in patients with a DSM‐defined depressive disorder.

What is the most effective form of therapy?

The most robustly studied, best-understood, and most-used is cognitive behavioral therapy. Other effective therapies include light therapy, hypnosis, and mindfulness-based treatments, among others.

Is CBT the best treatment for depression?

CBT has been found superior to control conditions and as efficacious as other psychotherapies and ADM in the acute treatment of depression. When adequately implemented, CBT can be as efficacious as ADM for patients with more severe depressions.

Is CBT the most effective therapy?

Research shows that CBT is the most effective form of treatment for those coping with depression and anxiety. CBT alone is 50-75% effective for overcoming depression and anxiety after 5 – 15 modules. Medication alone is effective, however, science still does not understand the long-term effects on the brain and body.

What is the management of depression?

Management of depression involves comprehensive assessment and proper establishment of diagnosis. The assessment must be based on detailed history, physical examination and mental state examinations. History must be obtained from all sources, especially the family.

What is depression in health?

INTRODUCTION. Depression is a common disorder, which often leads to poor quality of life and impaired role functioning. It is known to be a major contributor to the global burden of diseases and according to World Health Organization (WHO), depression is the fourth leading cause of disability worldwide and it is projected that by 2020, ...

What to do after discontinuing treatment?

After the discontinuation of active treatment, patients shouldbe reminded of the potential for a depressive relapse. Patient may be again informed about the early signs of depression, and a plan for seeking treatment in the event of recurrence of symptoms may be formulated.

What are the determinants of psychotherapy?

The major determinants of type of psychotherapy are patient preference and the availability of clinicians with appropriate training and expertise in specific psychotherapeutic approaches. Other clinical factors which will influence the type of psychotherapy include the severity of the depression.

What is the first line of antidepressants?

In general, because of the side effect and safety profile, selective serotonin reuptake inhibitors (SSRIs) are considered to be the first line antidepressants. Other preferred options include tricyclic antidepressants, mirtazapine, bupropion, and venlafaxine.

What is the goal of acute phase treatment?

The goal of acute phase treatment is to achieve remission, as presence of residual symptoms increase the risk of chronic depression, poor quality of life and also impairs recovery from physical illness. Treatment generally results in improvement in quality of life and better functional capacity.

Is depression a risk factor?

It is also reported to be a risk factor for the onset and persistence of a wide range ...

What is the most evidence based treatment for depression?

EVIDENCE BASE FOR COGNITIVE BEHAVIORAL THERAPY IN DEPRESSION. Cognitive behavioral therapy ( CBT) is one of the most evidence-based psychological interventions for the treatment of several psychiatric disorders such as depression, anxiety disorders, somatoform disorder, and substance use disorder.

What is the cognitive behavioral model of depression?

Cognitive behavioral therapy model of depression. Schema - stable internal structure of information usually formed during early life, also include core belief about self. information processing and intermediate belief are usually interpreted as rules of living and usually expressed in terms of “if and then” sentences.

What is the most common psychiatric disorder?

Depressive disorders are one of the most common psychiatric disorders that occur in people of all ages across all world regions. Although it may present at any age however adolescence to early adults is the most common age of onset, and females are affected two times more in comparison to the males.

What are some behavioral activities that help people stay grounded in the present?

Other important behavioral activities are:-. Mindfulness meditation: Helps people stay grounded in the present by keeping away from ruminations.

How does intellectual level affect treatment?

Intellectual level of the patient might also affect the overall effectiveness of the treatment. Willingness and motivation on the part of patients: Although it is not prerequisite, patients who are motivated to analyze their feelings and ready to undergo various homework show a better response to treatment.

Is CBT effective for depression?

A meta-analysis of 115 studies has shown that CBT is an effective treatment strategy for depression and combined treatment with pharmacotherapy is significantly more effective than pharmacotherapy alone.[2] .

How many people in the US have major depressive disorder?

Major depressive disorder is a serious illness that in the United States alone is estimated to affect 13 to 14 million adults each year. The lifetime prevalence rate (16%) is even higher, with an estimated 32 to 35 million US residents expected to develop the disorder at some point during their lifetime.

Is cognitive therapy effective for depression?

Studies have shown that cognitive therapy is as efficacious as antidepressant medications at treating depression, and it seems to reduce the risk of relapse even after its discontinuation. Cognitive therapy and antidepressant medication probably engage ...

Can you recover from ADM?

However, those who recover from depression with ADM but then discontinue the treatment have a risk of experiencing a new episode of depression (recurrence) that is three to five times the risk of a member of the general population experiencing a first episode of depression.

Is CT a good treatment for depression?

Like ADM, it is a safe and efficacious treatment for acute episodes of major depressive disorder. CT is based on the premise that inaccurate beliefs and maladaptive information processing (forming the bases for repetitive negative thinking) have a causal role in depression.

Is depression a disorder?

Depression can be defined as both a syndrome and a disorder. As a syndrome it involves episodes of sadness, loss of interest, pessimism, negative beliefs about the self, decreased motivation, behavioural passivity, changes in sleep, appetite and sexual interest, and suicidal thoughts and impulses.

Is CT as effective as ADM?

The evidence shows that that CT is as efficacious as ADM , and that its effects are more enduring. Thus, even if CT and ADM work through the same mechanisms in the same temporal order to reduce depressive symptoms, any enduring effects of CT must be produced by mechanisms that are not mobilized in the same way by ADM.

What is the best treatment for depression?

Based on these and other studies, the American Psychiatric Association (APA) recommends psychotherapy or medication as first-line treatments for mild to moderate depression; for individuals with more severe depression they recommend a combination of both. 2.

How long does a depression treatment last?

Thus the full course of treatment may last from 3 to 6 months, and longer in some cases if needed. The APA recommends that those with a long history of depression continue to receive therapy on an ongoing basis, often with a reduction in frequency of sessions.

What are the causes of depression?

The basic version of the theory was that depression was caused by low levels of neurotransmitters in the brain—chemicals like serotonin and norepinephrine. If these biological factors were driving depression, it made sense to assume that the best way to fix the underlying problem was with a biological solution.

Is psychotherapy cheaper than medication?

Because of the lasting effects of psychotherapy, it tends to be cheaper than medication, at least in the long run. One analysis suggested that the cost of CBT is about double that of medication for the first 16 weeks of treatment, but that the need for ongoing medication leads to higher costs in the months that follow.

Is CBT a good addition to medication?

Thus treatments like cognitive behavioral therapy (CBT) were considered to be possibly useful additions to medication, but not serious treatments in their own right (except perhaps for brief, mild forms of depression). When I was in graduate school I thought the chemical imbalance theory was true. So when I reviewed a wide range ...

Is mental health treatment cheap?

Good treatment is not cheap, and the cost varies greatly depending on several factors: Insurance coverage. Many mental health professionals practice outside of insurance networks because of the low payments in-network providers must agree to and the administrative burden, among other factors.

Is depression a generic drug?

The vast majority of drugs used to treat depression are available in generic form, making them much more affordable than brand- name medication. Insurance coverage might also vary depending on the drug, which can greatly affect the cost of treatment. Length of treatment.

What are the treatment outcomes for depression?

Treatment outcomes for depression: challenges and opportunities. Depressive disorders are common, costly, have a strong effect on quality of life, and are associated with considerable morbidity and mortality. Effective treatments are available: antidepressant medication and talking therapies are included in most guidelines as first-line treatments.

How many trials have been conducted on antidepressants?

In the past decades, more than 500 randomised trials have examined the effects of antidepressant medications, and more than 600 trials have examined the effects of psychotherapies for depression (although comparatively few are conducted for early-onset depression).

How many drug trials have low risk of bias?

However, less than 20% of drug trials and less than 30% of therapy trials have low risk of bias, making the outcomes uncertain. Typically, such trials do not have sufficient statistical power to examine for whom a treatment is effective, resulting in no reliable evidence on who benefits most from which treatment.

Is depressive disorder a costly disease?

Institutional Access. Depressive disorders are common, costly, have a strong effect on quality of life, and are associated with considerable morbidity and mortality. Effective treatments are available: antidepressant medication and talking therapies are included in most guidelines as first-line treatments.

What is the best treatment for depression?

In contrast, the American Psychiatric Association 3 recommends CT, interpersonal therapy, problem-solving therapy, and psychodynamic psychotherapy as effective interventions for depression but limits the recommendation to only mild to moderate depression.

How many samples per condition are considered evidence that treatments are equivalent?

They suggest that studies with samples per condition of at least 25 that demonstrate an intervention is not significantly inferior to an already validated intervention can be considered evidence that treatments are equivalent.

Is cognitive therapy effective for MDD?

To date, the evidence supports the effectiveness of both cognitive and dynamic therapies in the treatment of MDD, which suggests that the American Psychological Association should also consider revising their treatment guidelines. At the population level, both treatments offer a reasonable approach to helping alleviate the symptoms of depression. In practice, however, clinicians must decide which treatments are best suited to individual patients.

How many people are affected by depression?

Depression is the most prevalent psychiatric disorder, which affects more than 300 million individuals [ 2 ]. It is an incapacitating disorder, responsible for most of the 800,000 annual suicides [ 2 ]. Along with population growth and aging, the number of individuals with depression has also increased considerably and led to overloaded healthcare ...

What are the recommendations of CPGs?

All CPGs included recommendations for the treatment of those who did not respond or partially responded to first-line therapy . Such recommendations are synthesized in Table 3 and details are presented in S2 Table. Almost all recommendations were considered strong regarding the adjustment of drug dosages when there was a lack of response to the initial pharmacological treatment. Moreover, antipsychotic agents were recommended as an augmentation strategy by five CPGs.

Is pharmacological treatment for depression considered a strategy?

First, it should be noted that pharmacological treatment of depression is one of the strategies that should be considered to ensure adequate patient care. Pharmacotherapy should be prescribed only after a careful evaluation of the patient, including risk of suicide, requirement of hospitalization, indication of psychotherapy, and existence of comorbidities among other clinical and psychosocial aspects.

Is SSRI a first line treatment?

All CPGs considered SSRIs as a first-line antidepressant treatment . However, we identified two important discrepancies. Besides SSRIS, as options, the CANMAT CPG recommended the use of agomelatine, milnacipran, and mianserin [ 25 ]; and the Colombian CPG recommended the use of amitriptyline [ 22] as first-line treatment based on pharmacoeconomic studies.