Should combined pharmaco- and psychotherapy be offered to depressed patients?A qualitative review of randomized clinical trials from the 1990s.

摘要

Focusing on recent publications from the 1990s, this article qualitatively reviews the comparative efficacy of the combination of pharmaco- and psychotherapy (COMBI) vs either modality alone. There is only a weak empirical basis recommending the routine use of both psychotherapy and pharmacotherapy in acute treatment of Major Depressive Disorders (MDD). Concerning long-term treatment of MDD patients, the methodologically sophisticated study from Frank et al. shows that a COMBI is superior to interpersonal psychotherapy but not superior to medication alone. However, certain subgroups of patients might benefit substantially from COMBI compared to both psychotherapy and pharmacotherapy alone: 1) acute and long-term treatment of more severe forms of chronic depression, and 2) long-term treatment of older MDD patients. Compared to psychotherapy alone, severely depressed MDD patients profit more and faster when treated with combined psycho-pharmacotherapy.