Combined psychotherapy and pharmacotherapy for the treatment of major depressive disorder

Studies comparing the efficacy of combined psychotherapy and pharmacotherapy to single treatment (i.e., either psychotherapy or pharmacotherapy alone) for major depression have not found consistent differences in outcome, resulting in a range of conclusions regarding the efficacy of combined treatment. In order to clarify the efficacy of combined treatment for depression, the authors conducted both a meta-analytic and qualitative review. Our findings suggest that combined treatment is associated with a small improvement in efficacy, and that this finding appears consistent across studies. Trends in the literature suggest that adding psychotherapy to antidepressant medication may be particularly efficacious among chronic or severely depressed patients. Further, adding cognitive-behavioral therapy to medication may be particularly efficacious in preventing relapse, particularly among individuals discontinuing medication use. The authors propose an illness-cognition model for better understanding outcomes in combined treatment.