What Is the Most Effective Treatment for Depression?

That was the question at the center of a recent study led by Sarah R. Braun of the University of Vienna in Austria. Braun and her colleagues chose to focus on bona fide treatments for depression and examine which of these approaches provide the best outcomes based on clinician and client ratings. “Bona fide” implies that a treatment adheres to high clinical standards and that it be intended for a clear therapeutic purpose with a distinct and specific motivation.

Some bona fide approaches for the treatment of depression, and those included in Braun’s study were cognitive behavioral therapy (CBT), non-CBT therapies such as psychodynamic therapy and behavior activation therapy, and finally, supportive therapies that comprised new and alternative methods, both bona fide and others.

Braun used 53 existing research studies to conduct her analysis. She utilized two methods of evaluation; the traditional meta-analysis and the mixed comparison or network meta-analysis. She looked at age, gender, comorbid conditions, length of therapy session, and symptom levels to arrive at her conclusions.

Her findings revealed that although specific approaches did emerge as more effective than others, there were conditions that influenced those outcomes. However, in general, supportive and alternative therapies were less effective than any of the bona fide therapies examined in this study. Broken down by therapy type, cognitive behavioral therapy appeared superior when the sessions were longer than 90 minutes, but when they were shorter, behavior activation therapy proved more beneficial.

Further, women responded better to CBT than men, but older individuals had better outcomes with behavior activation therapy, but only when it was conducted on an individual versus group level. Another interesting finding was that individuals with comorbid anxiety and depression saw the most significant improvements with CBT.

Surprisingly, Braun also found that some of the newest approaches resulted in the most positive outcomes, at least on an individual level. Self-esteem therapy, problem solving therapy, and cognitive behavioral analysis, treatments designed specifically for depression, all had very positive results, although the sample sizes studied were small compared to samples studied in other approaches. Additionally, clinical significance for supportive therapies was not consistent with the positive outcomes reported by clients and clinicians.

In sum, this study shows that there are a myriad of factors that influence treatment outcome above and beyond therapeutic approach. Braun added, “Future research should address patient characteristics, like gender, age or comorbid mental disorders, more explicitly and determine which treatments work best with which group of patients.”

Reference:
Braun, S.R., Gregor, B., Tran, U.S. (2013). Comparing bona fide psychotherapies of depression in adults with two meta-analytical approaches. PLoS ONE 8(6): e68135. doi:10.1371/journal.pone.0068135

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  • Brandi

    Brandi

    July 31st, 2013 at 9:10 PM

    Are some therapy treatments better than the others? Yes.

    but are the same treatments better for everybody? not really.

    my cousin and I both suffered from anxiety. while a group setting worked well for me it didn’t for her.

    so i would say what should be chose is the best treatment for that person.

  • Desi

    Desi

    August 1st, 2013 at 4:24 AM

    Again, as has been noted in the past, this is not something that one size fits all for. Depression is something that varies so much from person to person, and what works for one person may or may not be the the right fix for another. I think that a good therapist is always going to immediately recognize this and will be more than willing to take a chance and try some different things until you get that perfect little combination of what is working for each individual patient. If I went to someone who stated that something always worked for everyone, that would be when I would turn arpund and have to walk out because I think that we are all smart enough to realize that this is rarely the truth.

  • michael p

    michael p

    August 1st, 2013 at 8:14 PM

    “Cognitive behavioral therapy appeared superior when the sessions were longer than 90 minutes, but when they were shorter, behavior activation therapy proved more beneficial.”

    How do they determine how long a session should be? My mom who was in her fifties at the time was in therapy and they decided the sessions would be 40 minutes long. She had no role to play in deciding this and she felt longer sessions could work better. Her suggestion was met with dismissive answers from the therapist. Although she continued for some time I think it is very important to involve the client in deciding on a session’s duration.

  • Tammy

    Tammy

    November 18th, 2015 at 8:50 PM

    In light of my recent findings and revelations, I think that more careful study and consideration should be given to the customer’service
    History; medical, abuse, family, work, attendance all of these things because it will help to better understand what is going on exactly. For instance, it was always quickly assessed that I had major depressive issues taking me to the edge of suicide. I am 51 years old. I am a female that was never taken to the doctor unless I was dying. At the age of 49 I was awakened to the fact that I have PTSD. I have been receiving therapy ever since as much and as often as I could afford. 2 years ago I had a break down resulting from a break up.I began taking anti anxiety medicine. That’s when I found out what that pain in my chest was…. anxiety… I have GAD.
    I also found out at that time that I have a heart condition, upper aortic aneurysm. . 4.7, at 5 they will operate.
    Recently, because of all the medical things I have been unable to get a job. (I had a repeat in January, same person different day. I was put on zoloft and wellbutrin, Buspar)
    I had discovered that TBI has a high rate of chronic depression and thoughts of suicide.
    Now, I think that should be noted a lot more than a side note.. and greater in children younger than 12, not receiving proper treatment for lack of funds. Come on.
    I’ve been seeking help since I first had the chance… the first counselor I ever knew, she was a school counselor but I didn’t know any better and I admitted to her when I was 17 that I was afraid to be alone with myself because of an overwhelming urge to kill myself.
    So after all of these years, it’s been PTSD, GAD, SAD,CHRONIC depression and the effects of a moderate tbi… maybe even the heat stroke, the several times that my brother knocked me out.
    My brother was twisted and cruel.I’m just saying.

  • Tammy

    Tammy

    November 18th, 2015 at 9:01 PM

    That should be, “customer’s history.”
    My phone changes words on me.
    Speaking of words.. I have aphasia too… I thought it was some form of mental, verbal dislexia.. aphasia… it’s amazing how normal you feel after knowing that there is a name for this abnormal stuff.

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