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Increasing psychotherapy dose from 8 to 16 sessions does not improve social functioning in people with major depressive disorder receiving pharmacotherapy

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Question

Question

Are 16 psychotherapy sessions more effective than eight sessions in improving social functioning of patients with major depression receiving pharmacotherapy?

Patients

463 community-dwelling adults (aged 18–60 years) with DSM-IV major depressive disorder (with or without dysthymia) and baseline score ≥14 on the Hamilton Depression Rating Scale (HDRS). Exclusion criteria: presence of a mental disorder due to a medical condition, drug abuse, psychotic and/or dissociative disorder, communication barrier, adequate treatment with antidepressants during the present depressive episode, use of psychotropic medication other than those prescribed by the protocol, pregnancy or intention to become pregnant, being considered ‘too ill’, ‘too suicidal’ or not reliable enough to participate.

Setting

Outpatient clinic at a teaching hospital, Amsterdam; time period not stated.

Intervention

Eight or 16, 45-min sessions of short psychodynamic supportive pscyhotherapy. The first eight sessions were weekly for both groups, then the remaining sessions were fortnightly. All patients received medication according to an antidepressant protocol. First-line treatment was fluoxetine, followed by a switch to nortriptyline if fluoxetine …

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