Does adding psychotherapy to pharmacotherapy improve social functioning in the treatment of outpatient depression?
background To increase the probability of a long-term recovery from depression, a normal level of social functioning is essential. It is currently unknown whether combined therapy has a better outcome than pharmacotherapy with regard to social functioning.
method rct in outpatients with major depression. Baseline score of at least 14 points on
the 17-item Hamilton Depression Rating Scale (hdrs). Two conditions consist of pharmacotherapy(PhT) (n=84) and combined therapy (CoT) (pharmacotherapy plus 16 sessions of Short Psychoanalytic Supportive Psychotherapy, n=83). Efficacy was assessed using the 17-item hdrs, the Clinical Global Impression scale (cgi) of Severity and of Improvement, the depression subscale of the Symptom Checklist 90 (scl-90), the Quality of Life Depression Scale (qlds) and the Groningen Social Disability Schedule.
results Severity of depression decreased significantly (on the scl-90 depression subscale and the qlds) only in the CoT condition. A larger improvement in social functioning was demonstrated for remitted patients in comparison to non-remitted patients. The number of dimensions of social functioning that had improved significantly was higher in CoT compared with PhT.
conclusion There is moderate advantage of the CoT condition for both depressive symptoms and level of social functioning compared with PhT. We also found a positive association between severity of depression and level of social functioning.