Mental Elf readers have been voting for their favourite topics and top of the list at present are psychological therapies and depression. Us elves like to give people what they want, so here’s a review conducted by researchers in the Netherlands that summarises what we know about the effectiveness of different types of psychotherapy in treating different types of depression.
The researchers describe the results of a series of meta-analyses that explore different types of psychotherapy for different types of depression. They summarise the findings from these various meta-analyses and here’s what they found:
- Cognitive behaviour therapy, interpersonal psychotherapy, problem-solving therapy, non-directive supportive therapy and behavioural activation therapy are all effective treatments for adult depression
- Differences between types of psychotherapy are small
- The efficacy of psychotherapy for mild to moderate depression is about the same as the efficacy of drug therapy (antidepressants)
- Combined treatment (psychotherapy and drug therapy) is more effective than psychotherapy alone or drug therapy alone
- Psychotherapy is also effective in older adults, women with postpartum depression, patients with general medical disorders, inpatients, primary care patients, patients with chronic depression and in sub-threshold depression
But the authors sound a note of caution in their conclusion:
The effects of psychotherapy are probably overestimated because of publication bias and the relatively low quality of many studies in the field.
Cuijpers P, Andersson G, Donker T, van Straten A. Psychological treatment of depression: results of a series of meta-analyses. Nord J Psychiatry. 2011 Dec;65(6):354-64. doi: 10.3109/08039488.2011.596570. Epub 2011 Jul 20. [PubMed abstract]
“Cognitive behaviour therapy, interpersonal psychotherapy, problem-solving therapy, non-directive supportive therapy and behavioural activation therapy are all effective treatments for adult depression”. What are the best form of depression treatments fo children and young people?
There is a big study (randomised controlled trial) going on at the moment in England, comparing three main psychological therapies for moderate to severe depression in young people. It is called IMPACT (Improving Mood with Psychanalyticic and Cognitive Therapies). About 600 young people (and their parents) are randomised to either 28 sessions of psychoanalytic child & adolescent psychotherapy, 20 sessions of cognitive behavioural therapy, or 12 sessions of ‘specialist clinical care’ (an enhanced ‘treatment as usual’ arm). Hopefully when this study reports in a few years, we’ll know a lot more about what therapies are most effective for young people with depression. That knowledge doesn’t currently exist and this trial is the largest ever of its kind. There is also going to be some added research about what factors in the various therapies are effective, as more and more psychotherapy research is moving away from ‘brands’ and focusing on ‘common factors’ across the different models.