Although antidepressant medications are popular for treating depression, many patients prefer some form of psychological therapy. A recent study compared medication and training in problem solving, and reports that the two are equally effective in helping patients with depression.
Researchers at Oxford University in Oxford, England, studied 151 patients who enrolled in a 12-week treatment program for depression. All patients were referred by their primary physician, and none required hospitalization. The 116 women and 35 men had an average age of 35 years. About half reported having been treated for depression in the past, and about half reported a family history of the illness.
Patients were randomly assigned to four groups. One group got six training sessions in problem-solving techniques, administered by a trained general practitioner, while another got the same training administered by a trained nurse. A third group received antidepressant medication and visited their doctors every two weeks. The final group got both training and medication.
The patients completed ratings of their symptoms before the treatment and at 6, 12, and 52 weeks after it began. Their physicians completed similar ratings at the same intervals.
At both 12 and 52 weeks, the 116 patients who completed the study all showed significant improvement. There were no significant differences between the medication group and the therapy groups, and the combination of medication and therapy wasn’t any more effective than one or the other.
Writing in the January 1st issue of the British Medical Journal, the Oxford researchers report that over half the patients showed significant improvement after 12 weeks, with up to two-thirds showing improvement after 52 weeks.
The researchers concluded that training in problem solving, which focuses on identifying difficulties, choosing goals, and practicing solutions, is neither more nor less effective than taking medication. Nor did it matter who delivered the training.
Given these results, the researchers suggest that problem solving therapy should be offered to patients who prefer non-drug treatment. This training can be completed in primary care when appropriately trained personnel are available. They suggest that the training is most suitable for patients with moderate symptoms.
Jennifer is a clinical pharmacologist. She helps doctors of all medical specialties choose medications. Jennifer consults about drug dosage, interactions, and side effects.