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Evidence for the treatment of moderate depression: a systematic review

Published online by Cambridge University Press:  15 June 2017

D. Aherne ,
A. Fitzgerald Open the ORCID record for A. Fitzgerald [Opens in a new window] ,
C. Aherne ,
N. Fitzgerald ,
M. Slattery  and
N. Whelan
D. Aherne
Affiliation:
Counselling Department, University of Limerick, Limerick, Ireland
A. Fitzgerald
Affiliation:
Counselling Department, University of Limerick, Limerick, Ireland
C. Aherne*
Affiliation:
Counselling Department, University of Limerick, Limerick, Ireland
N. Fitzgerald
Affiliation:
Counselling Department, University of Limerick, Limerick, Ireland
M. Slattery
Affiliation:
Counselling Department, University of Limerick, Limerick, Ireland
N. Whelan
Affiliation:
Counselling Department, University of Limerick, Limerick, Ireland
*
*Address for correspondence: C. Aherne, Counselling Department, University of Limerick, Limerick, Ireland. (Email: declan.aherne@ul.ie)
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Abstract

Objectives

This study aims to investigate existing evidence for the effectiveness of psychological treatments and/or antidepressant medication as a treatment for those diagnosed with moderate levels of depression.

Methods

A PRISMA systematic review of articles using electronic research databases (2000–2014) was conducted to identify studies investigating the effectiveness of psychotherapy and/or medication as a treatment for people with moderate levels of depression. Search terms included moderate depression, psychotherapy and/or medication, depressive disorders, antidepressants, psychotherapy, mental health services, and randomized-controlled trial (RCT). The included studies were then assessed, extracted, and synthesised.

Results

A total of 14 studies met the inclusion criteria (11 RCTs and three additional studies) for this review. The findings of the systematic review indicate that there is limited evidence available specific to the treatment of moderate depression and that this research seems to suggest that psychotherapy or combined treatment has a beneficial effect.

Conclusions

Given that depression is one of the biggest challenges the world faces at present, further research is required to examine the effectiveness of treatment for different levels of depression severity.

Keywords

Antidepressant medicationdepressionpsychological treatmentssystematic reviewtreatment
Type
Review Articles
Information
Irish Journal of Psychological Medicine , Volume 34 , Issue 3 , September 2017 , pp. 197 - 204
Copyright
© College of Psychiatrists of Ireland 2017 

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References

American Psychiatric Association (APA) (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5). American Psychiatric Publishing: The United States.Google Scholar
Antoni, MH, Lehman, JM, Kilbourn, KM, Boyers, AE, Culver, JL, Alferi, SM, Yount, SE, McGregor, BA, Arena, PL, Harris, SD, Price, AA (2001). Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology 20, 20.Google Scholar
Bastos, A, Guimarães, L, Trentini, C (2013). Neurocognitive changes in depressed patients in psychodynamic psychotherapy, therapy with fluoxetine and combination therapy. Journal of Affective Disorders 151, 1066–1075.CrossRefGoogle ScholarPubMed
Beck, AT, Ward, C, Mendelson, M (1961). Beck depression inventory (BDI). Archives of General Psychiatry 4, 561–571.CrossRefGoogle Scholar
Bromet, E, Andrade, LH, Hwang, I, Sampson, NA, Alonso, J, de Girolamo, G, Kessler, RC (2011). Cross-national epidemiology of DSM-IV major depressive episode. BMC Medicine 9, 90.CrossRefGoogle ScholarPubMed
Carter, PA, Dyer, KA, Mikan, SQ (2013). Sleep disturbance, chronic stress, and depression in hospice nurses: testing the feasibility of an intervention. Clinical Journal of Oncology Nursing 17, 368–373.Google Scholar
Cerda, P, Cervelló, E, Cocca, A, Viciana, J (2011). Effect of an aerobic training program as complementary therapy in patients with moderate depression. Perceptual and Motor Skills 112, 761–769.Google Scholar
Cuijpers, P, Sijbrandij, M, Koole, SL, Andersson, G, Beekamn, AT, Reynolds, CF (2014). Adding psychotherapy to anti-depressant medication in depression and anxiety disorders: a meta-analysis. World Psychiatry 13, 56–67.Google Scholar
Cuijpers, P, van Straten, A, Bohlmeijer, E, Hollon, SD, Andersson, G (2010a). The effects of psychotherapy for adult depression are overestimated: a meta-analysis of study quality and effect size. Psychological Medicine 40, 211–223.Google Scholar
Cuijpers, P, van Straten, A, Schuurmans, J, van Oppen, P, Hollon, SD, Andersson, G (2010b). Psychotherapy for chronic major depression and dysthymia: a meta-analysis. Clinical Psychology Review 30, 51–62.Google Scholar
Cuijpers, P, van Straten, A, van Oppen, P, Andersson, G (2009). Psychotherapy versus the combination of psychotherapy and pharmacotherapy in the treatment of depression: a meta-analysis. Depression & Anxiety 26, 279–288.Google Scholar
The Economist (2014). The global crisis of depression: the low of the 21st century http://www.economistinsights.com/sites/default/files/presentations/The%20Global%20Crisis%20of%20Depression_summary%20paper.pdf. Accessed December 2014.Google Scholar
Fournier, JC, Derubeis, RJ, Hollon, SD, Dimidjian, S, Amsterdam, JD, Shelton, RC, Fawcett, J (2010). Antidepressant drug effects and depression severity. Journal of the American Medical Association 303, 47–53.Google Scholar
Fraudenstein, U, Jagger, C, Arthur, A, Donner-Banzhoff, N (2001). Treatment for late life depression in primary care: a systematic review. Family Practice 18, 321–327.Google Scholar
Gastpar, M, Singer, A, Zeller, K (2005). Efficacy and tolerability of Hypericum extract STW3 in long-term treatment with a once-daily dosage in comparison with sertraline. Pharmacopsychiatry 38, 78–86.Google Scholar
Gastpar, M, Singer, A, Zeller, K (2006). Comparative efficacy and safety of a once-daily dosage of Hypericum extract STW3-VI and citalopram in patients with moderate depression: a double-blind, randomised, multicentre, placebo-controlled study. Pharmacopsychiatry 39, 66–75.Google Scholar
Goldberg, D, Williams, P (1991). A User’s Guide to the General Health Questionnaire. nferNelson: London.Google Scholar
Hamamci, Z (2006). Integrating psychodrama and cognitive behavioral therapy to treat moderate depression. Arts in Psychotherapy 33, 199–207.Google Scholar
Hamilton, M (1960). A rating scale for depression. Journal of Neurology Neurosurgery and Psychiatry 23, 56–62.CrossRefGoogle ScholarPubMed
Kessler, RC, Berglund, P, Demler, O, Robert, J, Koretz, D, Merikangas, KR, Rush, AJ, Walters, EE, Wang, PS (2003). The epidemiology of major depressive disorder. Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289, 3095–3105.Google Scholar
Kessler, RC, Chiu, WT, Demler, O, Walters, EE (2005). Prevalence, severity, and comorbidity of twelve-month DSM-IV disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry 62, 617–627.CrossRefGoogle Scholar
Khan, A, Faucett, J, Lichtenberg, P, Kirsch, I, Brown, W (2002). A systematic review of comparative efficacy of treatments and controls for depression. PLoS One 7, e41778.Google Scholar
Khan, A, Faucett, J, Lichtenberg, P, Kirsch, I, Brown, WA (2012). A systematic review of comparative efficacy of treatments and controls for depression. PLoS One 7, e41778.Google Scholar
Kirsch, I, Deacon, BJ, Huedo-Medina, TB, Scoboria, A, Moore, TJ, Johnson, BT (2008). Initial severity and anti-depressant benefits: A meta-analysis of the data submitted to the Food and Drug Administration. Public Library of Science Medicine 5, e45.Google Scholar
Klein, MB, Lee, T, Brouillette, MJ, Sheehan, NL, Walmsley, S, Wong, DK, Conway, B, Hull, M, Cooper, C, Haidar, S, Vezina, S, (2014). Citalopram for the prevention of depression and its consequences in HIV-hepatitis C coinfected individuals initiating pegylated interferon/ribavirin therapy: a multicenter randomized double-blind placebo-controlled trial. HIV Clinical Trials 15, 161–175.Google Scholar
Le, H, Perry, DF, Stuart, EA (2011). Randomized controlled trial of a preventive intervention for perinatal depression in high-risk Latinas. Journal of Consulting and Clinical Psychology 79, 135–141.Google Scholar
Linde, K, Sigterman, K, Kriston, L, Rucker, G, Jamil, S, Meissner, K, Schneider, A (2015). Effectiveness of psychological treatments for depressive disorders in primary care: systematic review and meta-analysis. Annals of Family Medicine 13, 56–68.CrossRefGoogle ScholarPubMed
Moher, D, Shamseer, L, Clarke, M, Ghersi, D, Liberati, A, Petticrew, M, …, Stewart, LA (2015). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Reviews 4, 1.Google Scholar
National Institute for Health and Clinical Excellence (2009). The Guidelines Manual. National Institute for Health and Clinical Excellence: London.Google Scholar
Pampallona, S, Bollini, P, Tibaldi, G, Kupelnick, B, Munizza, C (2004). Combined pharmacotherapy and psychological treatment for depression: a systematic review. Archives of General Psychiatry 61, 714–719.Google Scholar
Paykel, E, Andrade, L, Njenga, F, Phillips, MR (2012). Changes needed in the classification of depressive disorders: options for ICD-11. The ICD-11 Classification of Mood and Anxiety Disorders 11, 37–42.Google Scholar
Rush, AJ, Thase, ME (1999). Psychotherapies for depressive disorders: a review. In Depressive Disorders: WPA Series Evidence and Experience in Psychiatry (ed. M. Maj and N. Sartorious), pp. 161–206. Wiley: Chichester.Google Scholar
Songprakun, W, McCann, TV (2012a). Effectiveness of a self-help manual on the promotion of resilience in individuals with depression in Thailand: a randomized controlled trial. BMC Psychiatry 12, 12.CrossRefGoogle Scholar
Songprakun, W, McCann, TV (2012b). Evaluation of a cognitive behavioural self-help manual for reducing depression: a randomized controlled trial. Journal of Psychiatric and Mental Health Nursing 19, 647–653.CrossRefGoogle ScholarPubMed
Spijker, J, de Graaf, R, Bijl, RV, Beekman, AT, Ormel, J, Nolen, WA (2004). Determinants of persistence of major depressive episodes in the general population: results from the Netherlands Mental Health Survey and Incidence Study (NEMESIS). Journal of Affective Disorders 81, 231–240.CrossRefGoogle ScholarPubMed
Stötter, A, Mitsche, M, Endler, PC, Oleksy, P, Kamenschek, D, Mosgoeller, W, Haring, C (2013). Mindfulness-based touch therapy and mindfulness practice in persons with moderate depression. Body, Movement and Dance in Psychotherapy 8, 183–198.Google Scholar
Tao, JQ (2006). Jieyu pill versus venlafaxine extended release in the treatment of depression at different levels of severity. Chinese Journal of Clinical Rehabilitation 10, 1–3.Google Scholar
Uebelhack, R, Gruenwald, J, Graubaum, HJ, Busch, R (2004). Efficacy and tolerability of Hypericum extract STW 3-VI in patients with moderate depression: a double-blind, randomized, placebo-controlled clinical trial. Advances in Therapy 21, 265–275.Google Scholar
Üstün, TB, Ayuso-Mateos, JL, Chatterji, S, Mathers, C, Murray, CJ (2004). Global burden of depressive disorders in the year 2000. The British Journal of Psychiatry 184, 386–392.Google Scholar
van der Lem, R, van der Wee, NJ, van Veen, T, Zitman, FG (2012). Efficacy versus effectiveness: a direct comparison of the outcome of treatment for mild to moderate depression in randomized controlled trials and daily practice. Psychotherapy and Psychosomatics 81, 226–234.Google Scholar
Wittchen, HU, Jacobi, F, Rehm, J, Gustavsson, A, Svensson, M, Jönsson, B, Steinhausen, HC (2011). The size and burden of mental disorders and other disorders of the brain in Europe 2010. European Neuropsychopharmacology 21, 655–679.Google Scholar
World Health Organisation (WHO) (2012). Depression is a common illness and people suffering from depression need support and treatment (http://www.who.int/mediacentre/news/notes/2012/mental_health_day_20121009/en/). Accessed 15 December 2016.Google Scholar
Yeung, WF, Chung, KF, Ng, KY, Yu, YM, Ziea, ETC, Ng, BFL (2014). A systematic review on the efficacy, safety and types of Chinese herbal medicine for depression. Journal of Psychiatric Research 57, 165–175.Google Scholar
Zhou, X, Michael, KD, Liu, Y, Del Giovane, C, Qin, B, Cohen, D, Gentile, S, Xie, P, (2014). Systematic review of management for treatment-resistant depression in adolescents. BMC psychiatry 14, 1.Google Scholar