Hello Mentalhealth,
My search returned the following results for information about the
improvement of the therapeutic outcome when talk therapy is conducted
in conjunction with medicine.
I found numerous studies and articles that have revealed that a
combination of medication and talk therapy produce better results than
either treatment alone. I will provide you with the abstract of these
studies and a link to the full text article when available.
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In a study published in The New England Journal of Medicine, May 18,
2000, researchers found that a combination of short-term treatment of
an antidepressant and talk therapy designed to change behavior
patterns.
The New England Journal of Medicine
Volume 342:1462-1470 May 18, 2000 Number 20
A Comparison of Nefazodone, the Cognitive Behavioral-Analysis System
of Psychotherapy, and Their Combination for the Treatment of Chronic
Depression
Conclusions:
“Although about half of patients with chronic forms of major
depression have a response to short-term treatment with either
nefazodone or a cognitive behavioral-analysis system of psychotherapy,
the combination of the two is significantly more efficacious than
either treatment alone.“
The New England Journal of Medicine
http://content.nejm.org/cgi/content/abstract/342/20/1462
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Journal of Psychotherapy Practice and Research
April 2001
Adding Group Psychotherapy to Medication Treatment in Dysthymia
A Randomized Prospective Pilot Study
“Patients with dysthymia have been shown to respond to treatment with
antidepressant medications, and to some degree to psychotherapy.
(..)
The authors describe a prospective randomized 36-week study of
dysthymic patients, comparing continued treatment with antidepressant
medication (fluoxetine) alone and medication with the addition of
group therapy treatment.”
(..)
Conclusions:
“Results provide preliminary evidence that group therapy may provide
additional benefit to medication-responding dysthymic patients,
particularly in interpersonal and psychosocial functioning.”
Journal of Psychotherapy Practice and Research
http://jppr.psychiatryonline.org/cgi/content/abstract/10/2/93
“Patients in combined treatment demonstrated significant improvement
on a variety of symptom and interpersonal functioning measures, with
greater improvement on some measures than was found with medication
treatment alone.”
You may download the full text of this study here:
http://jppr.psychiatryonline.org/cgi/reprint/10/2/93.pdf
This file is in Adobe Acrobat (PDF) format.
You can get this software for free from the Acrobat web site.
http://www.adobe.com/prodindex/acrobat/readstep.html
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Journal of Psychotherapy Practice and Research
2001 Spring
A randomized controlled trial comparing moclobemide and moclobemide
plus interpersonal psychotherapy in the treatment of dysthymic
disorder.
“The authors compared the outcomes of 35 outpatients with dysthymic
disorder randomized to receive either treatment with moclobemide and
interpersonal therapy (IPT) or moclobemide and routine clinical
management.”
(..)
“Patients in both treatment groups showed statistically significant
improvement in all measures across time. There was a nonsignificant
trend toward lower scores on Ham-D and MADRS for patients in the
moclobemide plus IPT group.”
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11264335&dopt=Abstract
“Both groups in the present study improved over time, and there was a
nonsignificant trend for additional gains in the IPT+medication
group.”
“Patients in the IPT+medication group developed a good therapeutic
alliance, and fewer dropped out than in the control group (6/16 and
11/19, respectively). After initially seeming skeptical, patients
became involved with the IPT propositions, accepting the therapeutic
optimism and seeking success experiences. The trend toward continuous
improvement in the experimental group makes sense considering that
medication shows its benefits early and psychotherapy usually takes
longer to work.”
You may view the full text of this study here:
Journal of Psychotherapy Practice and Research
http://jppr.psychiatryonline.org/cgi/content/full/10/2/117?view=full&pmid=11264335
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The following research report from April 2002 illustrates that
combined therapy is more effective than medication alone.
Journal of Affective Disorders
Volume 68, Issues 2-3 , April 2002, Pages 317-330
Sertraline and/or interpersonal psychotherapy for patients with
dysthymic disorder in primary care: 6-month comparison with
longitudinal 2-year follow-up of effectiveness and costs
Conclusions:
“Sertraline or Sertraline plus IPT was more effective than IPT alone
after 6 months. Over the long term (2 years), all three treatments
provide reasonably effective treatment for reducing symptoms of
dysthymia, but Sertraline or combining Sertraline with IPT is more
effective than IPT alone. Of these two more effective treatments,
subjects in the Sertraline plus IPT group had less health and social
service costs by $480 per person over 2 years. These findings
underscore the effects of combining pharmacotherapy and psychotherapy
and the economic value of this more comprehensive treatment of
dysthymia in primary care.”
Science Direct
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T2X-460M8MX-J&_coverDate=04%2F30%2F2002&_alid=115014243&_rdoc=1&_fmt=&_orig=search&_qd=1&_cdi=4930&_sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=48c83391b9dcd03aa060dd1edcdc57af
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This study assessed the efficacy of antidepressant treatment
(sertraline) and group cognitive behavior therapy, alone or in
combination, in primary dysthymia.
American Journal of Psychiatry
1999 Oct;156(10):1608-17
Treatment of primary dysthymia with group cognitive therapy and
pharmacotherapy: clinical symptoms and functional impairments.
Institute of Mental Health Research at Royal Ottawa Hospital, Ont.,
Canada.
Conclusions:
“Sertraline treatment effectively reduces the clinical symptoms and
functional impairments associated with dysthymia. Although the group
cognitive behavior therapy intervention was less effective in
alleviating clinical symptoms, it augmented the effects of sertraline
with respect to some functional changes, and in a subgroup of patients
it attenuated the functional impairments characteristic of dysthymia.”
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10518174&dopt=Abstract
Abstract
http://ajp.psychiatryonline.org/cgi/content/abstract/156/10/1608
You may access this article for 24 hours for US$7.00.
http://ajp.psychiatryonline.org/cgi/content/full/156/10/1608
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Cognitive-Behavioral Group Therapy With Medication for Depressed Gay
Men With AIDS or Symptomatic HIV Infection
OBJECTIVE:
“The feasibility and effectiveness of a combination of group
cognitive-behavioral therapy and medication for the treatment of
depression among gay men with AIDS or symptomatic HIV infection were
evaluated.”
“This demonstration project was conducted to evaluate the feasibility
and efficacy of group cognitive-behavioral therapy, .. plus adjunctive
antidepressant medication for treating depression among gay men with
AIDS or symptomatic HIV infection.”
(..)
“We believe that the approach combining modified group
cognitive-behavioral therapy and adjunctive medication that was used
in this project may be practical and useful for treating patients with
AIDS or symptomatic HIV infection who are depressed, particularly in
managed care and mental health center settings, and is worthy of
further study.”
The full text of this study is available here:
Psychiatric Services
http://ps.psychiatryonline.org/cgi/content/full/50/7/948
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British Journal of Psychiatry. 1990 Jan;156:73-8.
Treatment of depressed in-patients. Cognitive therapy plus medication,
relaxation plus medication, and medication alone.
Results:
“Cognitive therapy plus medication and relaxation plus medication
groups reported significantly fewer depressive symptoms and negative
cognitions at discharge than the medication alone group.”
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=2404539&dopt=Abstract
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Combined Treatment For Patients With Double Depression
Miller IW, Norman WH, Keitner GI.
Department of Psychiatry and Human Behavior, Brown University School
of Medicine, Providence, RI, USA.
“Inpatients with double depression were assigned to two types of
treatment: (1) pharmacotherapy and (2) combined treatment
(pharmacotherapy + cognitive-behavioral psychotherapy).”
“The results indicated that double-depressed patients who received the
combined treatment had significantly lower levels of depression and
higher social functioning at the end of treatment. However, no
significant differences between groups were found at the follow-up
assessments.”
“ These results suggest that the addition of cognitive-behavioral
psychotherapy may produce an improved short-term outcome for patients
with double depression.”
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10396008&dopt=Abstract
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Combining Psychotherapy And Antidepressants In The Treatment Of
Depression
de Jonghe F, Kool S, van Aalst G, Dekker J, Peen J.
J Affect Disord. 2001 May;64(2-3):217-29
The objective of this study was “to compare the efficacy of
antidepressants with that of antidepressants plus psychotherapy
("combined therapy") in the treatment of depression.”
“The difference in success rates is statistically significant,
favouring combined therapy, in 23%, 31% and 62% of the patients after
8, 16 and 24 weeks of treatment, respectively. At week 24, the mean
success rate is 40.7% in the pharmacotherapy group and 59.2% in the
combined therapy group.”
“ Patients found combined treatment significantly more acceptable,
they were significantly less likely to drop out of combined therapy
and, ultimately, significantly more likely to recover. Combined
therapy is preferable to pharmacotherapy in the treatment of
ambulatory patients with major depression.”
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11313088&dopt=Abstract
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Combined Psychotherapy And Pharmacotherapy For Depression. A
Systematic Analysis Of The Evidence
“The combined active treatments (drugs plus psychotherapy) were
appreciably more effective than the placebo conditions but only
slightly superior to psychotherapy alone, pharmacotherapy alone, or
either of these combined with a placebo.”
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=3516110&dopt=Abstract
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Treatment of Major Depression with Psychotherapy Or
Psychotherapy-Pharmacotherapy Combinations
Thase ME, Greenhouse JB, Frank E, Reynolds CF 3rd, Pilkonis PA, Hurley
K, Grochocinski V, Kupfer DJ.
Western Psychiatric Institute and Clinic, University of Pittsburgh
School of Medicine, Pa., USA.
This study found new evidence in support of the widespread clinical
impression that combined therapy is superior to psychotherapy alone
for treatment of more severe, recurrent depressions.
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9366657&dopt=Abstract
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Combined Medication And Psychotherapy In The Treatment Of Chronic Mood
Disorders by Miller IW, Keitner GI.
Department of Psychiatry and Human Behavior, Brown University School
of Medicine, Providence, Rhode Island, USA.
“The use of combination treatment involving pharmacotherapy,
individual psychotherapy, and marital/family therapy is recommended to
address the complex biopsychosocial issues involved in chronic mood
disorders.”
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8677217&dopt=Abstract
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J Clin Psychiatry 2000
Integration of Pharmacotherapy And Psychotherapy For Bipolar Disorder
Department of Psychiatry and Behavioral Sciences, Emory University
School of Medicine, Atlanta, Ga, USA.
The American Psychiatric Association recommends “an integration of
psychotherapeutic techniques with pharmacotherapy for the treatment of
bipolar disorder. Psychotherapy aims to address risk factors and
associated features that are difficult to address with pharmacotherapy
alone.”
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10826664&dopt=Abstract
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American Journal of Psychiatry 2002 Mar;159(3):466-8.
Combined Pharmacotherapy and Psychotherapy As Maintenance Treatment
For Late-Life Depression: Effects On Social Adjustment
Department of Psychiatry, University of Pittsburgh School of Medicine,
Pittsburgh, PA, USA.
“This study examined the effects of maintenance treatment for
late-life depression on social adjustment. The authors hypothesized
that elderly patients recovering from depression would have better
social adjustment with medication and interpersonal psychotherapy than
with medication or psychotherapy alone.”
CONCLUSIONS:
“Treatment of late-life depression with nortriptyline and
psychotherapy is more likely to maintain social adjustment than
treatment with either alone. Combination therapy improves not only
duration but quality of wellness.”
National Library of Medicine: PubMed
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11870013&dopt=Abstract
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From the Stanford Online Report:
Fighting chronic depression: Two therapies better than one
By Caroline Seydel
“Conventional wisdom among psychiatrists has dictated that people
suffering from chronic depression are best treated with a combination
of antidepressants and psychotherapy. Now, a large national study
confirms that combination therapy is more effective than either
medication or counseling alone.
The study, published May 18 in the New England Journal of Medicine,
shows that the antidepressant nefazodone hydrochloride (Serzone)
combined with psychotherapy specifically designed for chronic
depression offers the best treatment for people suffering from this
long-term form of depression”
Stanford Online Report
http://www.stanford.edu/dept/news/report/news/may24/depression-524.html
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Combined Treatment Is Best for Chronic Depression
“This large, well designed study demonstrated that combined treatment
is superior to medication or psychotherapy alone and reported a
surprisingly high rate of response in chronically ill patients.”
http://planneohio.org/combined.htm
Journal Watch Psychiatry 2000: 2-2
http://psychiatry.jwatch.org/content/vol2000/issue701/index.shtml
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Facts Sheets from the National Mental Health Association recommend
combination therapy as well.
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Steps to Overcome Depression:
“The most important step toward successful recovery is to seek
treatment. With the appropriate combination of "talk" therapy and
medication, people with depression can achieve remission (virtual
elimination) of symptoms and reconnect with life and with
relationships.”
“To resolve all your symptoms, a combination of medication and “talk”
therapy may be recommended.”
National Mental Health Association
http://www.nmha.org/infoctr/factsheets/depressionAndRelationships.cfm
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Helping a Suicidal Person:
”No single therapeutic approach is suitable for all suicidal persons
or suicidal tendencies. The most common ways to treat underlying
illnesses associated with suicide are with medication, talk therapy or
a combination of the two.”
National Mental Health Association
http://www.nmha.org/infoctr/factsheets/81.cfm
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Talk therapy or drug therapy: which is better?
by Bethanne Black
A combination is your best bet:
“Studies show that often the best management for psychiatric issues
comes from a combination of talk therapy and medication. Dr. Raskin
adds, "It's like taking muscle relaxants and undergoing physical
therapy for back strain: the two treatments work together to get you
back on your feet."
Somerset Medical Center
http://www.somersetmedicalcenter.com/14363.cfm
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According to Depression-screening.org:
“Clinical depression is one of the most readily treatable illnesses,
and getting treatment can truly save lives. The most common ways to
treat depression are with antidepressant medication, psychotherapy
(talk therapy), or a combination of both. The choice of treatment
depends on the severity of the depressive symptoms, history of the
illness and consumer preference. Research has shown that a combination
of psychotherapy and medication is often most effective.”
Depression-screening.org is sponsored by the National Mental Health
Association
http://www.depression-screening.org/symptoms/diagnosis002.htm
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Search Criteria:
Studies “combined treatment” “mental health”
Combined medication and psychotherapy
Combined Treatment +Depression
Importance talk therapy
“talk therapy” combination psychotropic medication
I hope the above information helps you in your research. If anything
is unclear or if a link does not function, please let me know and I’ll
be glad to offer further assistance.
Best Regards,
Bobbie7-ga |
