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Treatment of Depression

The Relevance of Research for Clinical Practice

Published online by Cambridge University Press:  02 January 2018

E. S. Paykel
E. S. Paykel*
Affiliation:
University of Cambridge, Addenbrooke's Hospital, Cambridge CB2 2QQ
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Extract

My aim in this lecture is to review a wide range of published studies on the treatment of depression. I want to look at these with one major clinical question in mind: given the range of treatments available, which treatment should be chosen for which patient? In July 1985 a report, published as a special supplement to the American Journal of Psychiatry, called for more research on this topic:

“As the number and diversity of the effective drugs and psychosocial interventions expand, clinicians will increasingly want objective, reliable criteria with which to match the patient to the optimal treatment modality and to monitor the response.” (Institute of Medicine, 1985)

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Type
Lecture
Information
The British Journal of Psychiatry , Volume 155 , Issue 6 , December 1989 , pp. 754 - 763
Copyright
Copyright © The Royal College of Psychiatrists, 1989 

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References

Abou-Saleh, M. T. & Coppen, A. (1983) Classification of depression and response to antidepressive therapies. British Journal of Psychiatry, 143, 601–603.Google Scholar
Abrams, R., Fink, M. & Feldstein, S. (1973) Prediction of clinical response to ECT. British Journal of Psychiatry, 122, 457–460.Google Scholar
Abrams, R. & Fink, M. (1984) The present status of unilateral ECT – some recommendations. Journal of Affective Disorders, 7, 245–247.Google Scholar
Akiskal, H. S. & McKinney, W. T. (1975) Overview of recent research in depression. Integration of ten conceptual models into a comprehensive clinical frame. Archives of General Psychiatry, 32, 285–305.Google Scholar
Ball, J. R. & Kiloh, L. G. (1959) A controlled trial of imipramine in treatment of depressive states. British Medical Journal, ii; 52–55.Google Scholar
Beck, A. T., Hollan, S. D., Young, J. E., et al (1985) Treatment of depression with cognitive therapy and amitriptyline. Archives of General Psychiatry, 42, 142–148.Google Scholar
Blackburn, I. M., Bishop, S., Glen, I. M., et al (1981) The efficacy of cognitive therapy in depression: a treatment trial using cognitive therapy and pharmacotherapy, each alone and in combination. British Journal of Psychiatry, 139, 181–189.Google Scholar
Blackburn, I. M., Funson, K. M. & Bishop, S. (1986) A two year naturalistic follow up of depressed patients treated with cognitive therapy, pharmacotherapy and a combination of both. Journal of Affective Disorders, 10, 67–75.Google Scholar
Brandon, S., Cowley, P., McDonald, C., et al (1984) Electroconvulsive therapy: results in depressive illness from the Leicestershire trial. British Medical Journal, 288, 22–25.Google Scholar
Clinical Research Centre, Division Of Psychiatry (1984) The Northwick Park ECT Trial. Predictors of response to real and simulated ECT. British Journal of Psychiatry, 144, 227–237.Google Scholar
Covi, L., Lipman, R. S., Derogatis, R., et al (1974) Drugs and group psychotherapy in neurotic depression. American Journal of Psychiatry, 131, 191–198.Google Scholar
Davidson, J., Pelton, S., Krishnan, R. R., et al (1986) The Newcastle anxiety depression index in relationship to the effects of MAOI and TCA drugs. Journal of Affective Disorders, 11, 51–61.Google Scholar
Davidson, J. R. T., Giller, E. L., Zisook, S., et al (1988) An efficacy study of isocarboxazid and placebo in depression, and its relationship to depressive nosology. Archives of General Psychiatry, 45, 120–127.Google Scholar
D'elia, G. & Raotma, H. (1975) Is unilateral ECT less effective than bilateral ECT? British Journal of Psychiatry, 126, 83–89.Google Scholar
DiMascio, A., Weissman, M. M., Prusoff, B. A., et al (1979) Differential symptom reduction by drugs and psychotherapy in acute depression. Archives of General Psychiatry, 36, 1450–1456.Google Scholar
Dobson, K. S. (1989) A meta-analysis of the efficacy of cognitive therapy for depression. Journal of Consulting & Clinical Psychology, 57, 414–419.Google Scholar
Elkin, I., Parloff, M., Hadley, S. & Autry, I. (1985) The NIMH Treatment of Depression Collaborative Research Program: background and research plan. Archives of General Psychiatry, 42, 305–316.Google Scholar
Freeman, C. P. L., Basson, J. V. & Creighton, A. (1978) Double-blind controlled trial of electroconvulsive therapy (ECT) and simulated ECT in depressive illness. Lancet, i, 738–740.Google Scholar
Friedman, A. S. (1975) Interaction of drug therapy with marital therapy in depressed patients. Archives of General Psychiatry, 32, 619–637.Google Scholar
Greenblatt, M., Grosser, G. H. & Wechsler, H. (1964) Differential response of hospitalised depressed patients to somatic therapy. American Journal of Psychiatry, 120, 935–943.Google Scholar
Gregory, S., Shawcross, C. R. & Gill, D. (1985) The Nottingham ECT study. A double-blind comparison of bilateral, unilateral and simulated ECT in depressive illness. British Journal of Psychiatry, 146, 520–524.Google Scholar
Hobson, R. F. (1953) Prognostic factors in electric convulsive therapy. Journal of Neurology, Neurosurgery and Psychiatry, 16, 275–281.Google Scholar
Hollon, S. D., Yuason, V. B., Weiner, M. J., et al (1984) Combined cognitive-pharmacotherapy vs cognitive therapy alone and pharmacotherapy alone in the treatment of depressed outpatients. Differential treatment outcome in the CPT project. Unpublished manuscript. Minneapolis, Minnesota: University of Minnesota & St Paul Ramsey Medical Center (cited in Simons et al, 1986).Google Scholar
Hollyman, J. E., Freeling, P., Paykel, E. S., et al (1988) Double-blind placebo-controlled trial of amitriptyline among depressed patients in general practice. Journal of The Royal College of General Practitioners, 38, 393–397.Google Scholar
Hutchinson, J. T. & Smedberg, D. (1963) Treatment of depression: a comparative study of ECT and six drugs. British Journal of Psychiatry, 109, 536–538.Google Scholar
Institute Of Medicine (1985) Research on mental illness and addictive disorders: progress and prospects. A report of the Board on Mental Health and Behavioral Medicine, Institute of Medicine. American Journal of Psychiatry, 142 (July Supplement).Google Scholar
Johnstone, E. C., Deakin, J. F. W., Lawler, P., et al (1980a) The Northwick Park electroconvulsive therapy trial. Lancet, ii, 1317–1320.Google Scholar
Johnstone, E. C., Cunningham Owens, D. G., Frith, C. D., et al (1980b) Neurotic illness and its response to anxiolytic and antidepressant treatment. Psychological Medicine, 10, 321–328.Google Scholar
Kahn, R. J., McNair, D. M., Lipman, R. S., et al (1986) Imipramine and chlordiazepoxide in depressive and anxiety disorders. Archives of General Psychiatry, 43, 79–85.Google Scholar
Kiloh, L. G., Child, J. P. & Latner, G. A. (1960) A controlled trial of iproniazid in the treatment of endogenous depression. Journal of Mental Science, 106, 1139–1144.Google Scholar
Kovacs, M., Rush, A. J., Beck, A. T., et al (1981) Depressed outpatients treated with cognitive therapy or pharmacotherapy. Archives of General Psychiatry, 38, 33–41.Google Scholar
Lam bourn, J. & Gill, D. (1978) A controlled comparison of simulated and real ECT. British Journal of Psychiatry, 133, 514–519.Google Scholar
Liebowitz, W. R., Quitkin, F. M., Stewart, J. W., et al (1988) Antidepressant specificity in atypical depression. Archives of General Psychiatry, 45, 129–137.Google Scholar
Marks, I. (1983) Are there anticompulsive or antiphobic drugs? Review of the evidence. British Journal of Psychiatry, 143, 338–347.Google Scholar
McLean, P. D. & Hakstian, A. R. (1979) Clinical depression: comparative efficacy of outpatient treatments. Journal of Consulting and Clinical Psychology, 47, 818–836.Google Scholar
Medical Research Council (1965) Clinical trial of the treatment of depressive illness. British Medical Journal, i, 881–886.Google Scholar
Morris, J. B. & Beck, A. T. (1974) The efficacy of antidepressant drugs: a review of research (1958–1972). Archives of General Psychiatry, 30, 667–674.Google Scholar
Murphy, G. E., Simons, K. D., Wetzel, R. D., et al (1984) Cognitive therapy and pharmacotherapy; singly and together in the treatment of depression. Archives of General Psychiatry, 41, 33–41.Google Scholar
Pare, C. M. B. & Mack, J. W. (1971) Differentiation of two genetically specific types of depression by the response to antidepressant drugs. Journal of Medical Genetics, 8, 306–309.Google Scholar
Parloff, M. B., Kelman, H. C. & Frank, J. D. (1954) Comfort, effectiveness and self-awareness as criteria of improvement in psychotherapy. American Journal of Psychiatry, 111, 343–351.Google Scholar
Paykel, E. S. (1979) Predictors of treatment response. In Psychopharmacology of Affective Disorders, pp. 193–220. Oxford: Oxford University Press.Google Scholar
Paykel, E. S. (1988) Antidepressants: their efficacy and place in therapy. Journal of Psychopharmacology, 2, 105–108.Google Scholar
Paykel, E. S. (1989) Monoamine oxidase inhibitors: when should they be used? In Dilemmas and Controversies in the Management of Psychiatric Patients (eds Hawton, K. & Cowen, P.). Oxford: Oxford University Press (in press).Google Scholar
Paykel, E. S., DiMascio, A., Haskell, D., et al (1975) Effects of maintenance amitriptyline and psychotherapy on symptoms of depression. Psychological Medicine, 5, 67–77.Google Scholar
Paykel, E. S., DiMascio, G. L., Klerman, G. L., et al (1976) Maintenance therapy of depression. Pharmakopsychiatrie Neuro-Psychopharmacologie, 9, 127–136.Google Scholar
Paykel, E. S., Rowan, P. R., Parker, R. R., et al (1982) Response to phenelzine and amitriptyline in subtypes of neurotic depression. Archives of General Psychiatry, 39, 1041–1049.Google Scholar
Paykel, E. S., Parker, R. R., Rowan, R. R., et al (1983) Nosology of atypical depression. Psychological Medicine, 13, 131–139.Google Scholar
Paykel, E. S., Hollyman, J. A., Freeling, P., et al (1988) Predictors of therapeutic benefit from amitriptyline in mild depression: a general practice placebo-controlled trial. Journal of Affective Disorders, 14, 83–95.Google Scholar
Perry, P. J., Morgan, D. E., Smith, R. E., et al (1982) Treatment of unipolar depression accompanied by delusions. ECT versus tricyclic antidepressant-antipsychotic combinations. Journal of Affective Disorders, 4, 195–200.Google Scholar
Pollitt, J. (1965) Depression and its Treatment. London: Heinemann.Google Scholar
Prusoff, B. A., Weissman, M. M., Klerman, G. L., et al (1980) Research Diagnostic Criteria subtypes of depression. Their role as predictors of differential response to psychotherapy and drug treatment. Archives of General Psychiatry, 37, 796–801.Google Scholar
Rao, V. A. & Coppen, A. (1978) Classification of depression and response to amitriptyline therapy. Psychological Medicine, 9, 3231–3325.Google Scholar
Ravaris, C. L., Robinson, D. S., Ives, J. O., et al (1980) Phenelzine and amitriptyline in the treatment of depression. Archives of General Psychiatry, 37, 1075–1080.Google Scholar
Robin, A. & de Tissera, S. (1982) A double-blind controlled comparison of the therapeutic effects of low and high energy electroconvulsive therapies. British Journal of Psychiatry, 141, 357–366.Google Scholar
Robinson, D. S., Nies, A., Ravaris, C. L., et al (1974) Treatment response to MAO inhibitors: relation to depressive typology and blood platelet MAO inhibition. In Classification and prediction of outcome of depression, pp. 259–267. Stuttgart: Schattauer-Verlag.Google Scholar
Rowan, P. R., Paykel, E. S. & Parker, R. R. (1982) Phenelzine and amitriptyline: effects on symptoms of neurotic depression. British Journal of Psychiatry, 140, 475–483.Google Scholar
Rush, A. J., Beck, A. T., Kovacs, M., et al (1977) Comparative efficacy of cognitive therapy and pharmacotherapy in the treatment of depressed outpatients. Cognitive Therapy and Research, 1, 17–37.Google Scholar
Sackeim, H. A., Decina, P., Kanzler, M., et al (1987) Effects of electrode placement on the efficacy of titrated, low-dose ECT. American Journal of Psychiatry, 144, 1449–1455.Google Scholar
Simons, A. D., Murphy, G. E., Levine, J. L., et al (1986) Cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry, 43, 43–50.Google Scholar
Stanley, W. J. & Fleming, H. (1962) A clinical comparison of phenelzine and electro-convulsive therapy in the treatment of depressive illness. Journal of Mental Science, 108, 708–710.Google Scholar
Stewart, J. W., Quitkin, F. M., Liebowitz, M. R., et al (1983) Efficacy of desipramine in depressed outpatients: response according to Research Diagnostic Criteria and severity of illness. Archives of General Psychiatry, 40, 202–207.Google Scholar
Stewart, J. W., McGrath, P. J., Liebowitz, M. R., et al (1985) Treatment outcome validation of DSM–III depressive subtypes: clinical usefulness in outpatients with mild to moderate depression. Archives of General Psychiatry, 42, 1148–1153.Google Scholar
Teasdale, J. D., Fennell, M. J. V., Hibbert, G. A., et al (1984) Cognitive therapy for major depressive disorder in primary care. British Journal of Psychiatry, 144, 400–406.Google Scholar
Tyrer, P. (1976) Towards rational therapy with monoamine oxidase inhibitors. British Journal of Psychiatry, 128, 354–360.Google Scholar
Uhlenhuth, E. H. & Park, L. C. (1964) The influence of medication (imipramine) and doctor in relieving depressed psychoneurotic patients. Journal of Psychiatric Research, 2, 101.Google Scholar
West, E. D. (1981) Electric convulsion therapy in depression: a double-blind controlled trial. British Medical Journal, 282, 355–357.Google Scholar
West, E. D. & Dally, P. J. (1959) Effects of iproniazid in depressive syndromes. British Medical Journal, i, 1491–1499.Google Scholar
Wittenborn, J. R., Plante, M., Burgess, F., et al (1962) A comparison of imipramine, ECT and placebo in the treatment of depression. Journal of Nervous and Mental Disease, 135, 131–137.Google Scholar
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