Cumulative effect of psychotherapy in remission of symptomatology of major depressive disorder

Abstract

Background: Major depressive disorder constitutes the most commonly appeared psychological disorder. The aim of this study was to investigate the cumulative effect of psychotherapy over drug therapy in remitting depressive symptoms was examined. Method-materials: The sample consisted of 62 patients given the diagnosis of major depressive disorder who suffered in the past two years with at least 2 major depressive episodes. Additional inclusion criteria were, age of patients to be between 26-60 years old, onset of disorder ≥4 years, and weight of symptomatology having scores in MADRS ≥34 and in CGI ≥5. All patients were assigned randomly in four groups of combined therapy. The progress of depressive symptoms was measured with taxonomic manuals of psychological diseases MADRS from 1rst week of hospitalization, and every 3 weeks, until the 24th week of treatment. Results: Of the 42 participants, 24 were male and 38 female with mean age 42,3±8,8 years. The statistical significant improvement on depressive symptoms (p<0.001) occurred from induction week (MADRS=41) to the 6th week (MADRS=32) of hospitalization defined the level of remission of depressive symptoms. This remission mostly was a mixed effect of drug therapy and psychotherapy, since all 4 groups of patients showed similar decline in MADRS scores. Maintenance phase occurred about the 3rd month of treatment (MADRS=14), at which point the greater cumulative effect over pharmacotherapy was that of psychodynamic-analytical therapy at 6th month with 52% remission (p<0.001) from baseline, while that of cognitive-behavioral therapy was 40%, and respectively only 22% for the supportive therapy. Conclusions: Remission rate of depressive symptoms occurred about the 6th week of hospitalization, with maintenance phase to occur at 12th week of treatment, time point at which psychodynamic and cognitive-behavioral psychotherapy had a statistical and clinical greater effect over drug therapy on remission maintenance of depressive symptoms compared to supportive therapy. © All rights reserved