Faculty & Staff

Given the recurrent nature of major depressive disorder (MDD), multiple phases of treatment are recommended. This review evaluates the efficacy of cognitive, interpersonal, and related psychotherapies for MDD during the acute, continuation, and maintenance phases, both singly and combined with antidepressant medication. Acute phase studies have generally found that psychotherapy and ADM are equally effective, with a combination of the two being superior to monotherapy. Research findings also suggest that cognitive therapy is associated with a lower risk of relapse/recurrence than antidepressants, and switching strategies – i.e. changing from antidepressants to psychotherapy or vice versa – appears to be beneficial for non-responders during the acute phase. Continuation phase treatment studies report that psychotherapy is better than treatment cessation in terms of relapse prevention, but does not provide further benefit when added to ongoing pharmacotherapy. Maintenance phase studies have shown that, in terms of recurrence prevention, psychotherapy is superior to minimal or no treatment, as well as to treatment as usual in patients with multi-episode histories. There is conflicting evidence as to whether psychotherapy prevents recurrence as effectively as maintenance antidepressant medications, and on the benefits of the addition of psychotherapy to antidepressants. However, the provision of psychotherapy following cessation of pharmacotherapy appears to be an effective strategy for recurrence prevention.