Cited by 515Treatment of Major DepressionPsychotherapy Techniques and ApplicationsAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Treatment of Major Depression With Psychotherapy or Psychotherapy-Pharmacotherapy Combinations

Thase, Michael E.·1997·Archives of General Psychiatry

DOI 10.1001/archpsyc.1997.01830230043006

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Abstract

BACKGROUND: Few reliable correlates of treatment response in depression have emerged despite nearly 40 years of research. We examined the correlates of recovery in a "mega-analysis," or meta-analysis of original data, of 595 patients with major depressive disorder enrolled in 6 standardized treatment protocols. METHODS: All patients (mean age, 44 years; 31% male and 69% female) met criteria for nonbipolar, nonpsychotic primary major depressive disorder and were treated for 16 weeks with either cognitive behavior therapy or interpersonal psychotherapy alone (psychotherapy alone; n = 243) or interpersonal psychotherapy plus antidepressant pharmacotherapy (combined therapy; n = 352). The impact of treatment type, severity, study, and other covariates on recovery rates or time to recovery were examined by means of chi 2, log-rank tests, the Cox proportional hazards model, and sensitivity analyses. RESULTS: Whereas combined therapy was not significantly more effective than psychotherapy alone in milder depressions, a highly significant advantage was observed in more severe recurrent depressions. Poorer outcomes were also observed in women and older patients, although these effects were dependent on inclusion of particular studies. CONCLUSIONS: Mega-analysis is a powerful method for comparing the efficacy of treatments and examining correlates of response. Using this method, we 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.

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Authors: Thase, M. E.
Affiliations: University of Pittsburgh (US)
Corresponding author: Thase, Michael E.
ORCID: Thase, Michael E.
Venue: Archives of General Psychiatry
Publisher: American Medical Association (AMA)
Published: 1997-11-01
Volume: 54
Issue: 11
Pages: 1009
ISSN: 0003-990X (ISSN-L)
DOI: 10.1001/archpsyc.1997.01830230043006
OpenAlex: W2024671640
Cited by: 515
References: 51
Citations by year: 2026: 5 · 2025: 8 · 2024: 4 · 2023: 8 · 2022: 6 · 2021: 1 · 2020: 11 · 2019: 15 · 2018: 9 · 2017: 15 · 2016: 16 · 2015: 14 · 2014: 15 · 2013: 22 · 2012: 19
FWCI: 12.39
Type: journal article
Language: en
Open access: closed
Locations: Archives of General Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5t32mh015758-16)
National Institute of Mental Health (MH-41884, R01MH040023, MH-15758, R01MH041884, MH-40023)
Topics: Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: major depressive disorder, psychotherapy, cognitive behavioral therapy, interpersonal psychotherapy, antidepressant treatment, treatment response, recovery time, depression severity, recurrent depression, sex differences, age differences, mega-analysis
MeSH terms: Adult, Aged, Antidepressive Agents, Clinical Protocols, Combined Modality Therapy, Depressive Disorder, Female, Humans, Male, Middle Aged, Psychotherapy, Regression Analysis, Cognitive Behavioral Therapy, Proportional Hazards Models, Survival Analysis, Randomized Controlled Trials as Topic, Treatment Outcome

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Treatment of Major Depression With Psychotherapy or Psychotherapy-Pharmacotherapy Combinations

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