Sunday, May 3, 2015

Treatment of depression is getting cheaper

Depression is one of the major mental disorders, and is highly burdening on the daily life of the patients. Overcoming depression is a common ambition of all clinical practitioners of mental health.

Cognitive Behavioral Therapy (CBT) and some other psychotherapies have been proven to be effective as much as antidepressant medication in treating depression. However, they are time-consuming. In addition, limited number of skilled therapists makes it difficult to provide proper therapy to all the patients suffering from depression.

Recently, therefore, less intensive psychotherapies such as computer-based CBT and self-guided psychotherapy were considered to be introduced in clinical setting. They are easy for general practitioners to perform, and far less expensive.

For their superficial impression, some specialists are doubtful about the effectiveness of these new-age therapies. Even if they were inferior to classic CBT, however, the spread of their use would help not a few patients, especially in the primary care setting.

The fact was more surprising.

Linde et al. in Germany investigated the research papers describing clinical trials of psychotherapy for depression in the primary care setting comprehensively, to meta-analyze their effect size and compared them each other.

They extracted 100 papers from electrical and paper database. Seventy studies were excluded for some deficits in the methodology. Finally, they evaluated the effect of remained 30 studies. As a result, remote CBT and guided self-help CBT were not inferior to face-to-face CBT. Problem-solving therapies failed to show the significant effectiveness because of limited number of studies.

Medline: Effectiveness of psychological treatments for depressive disorders in primary care: systematic review and meta-analysis.

According to this study, skilled psychotherapists are no more useful in the treatment of depression. A textbook or internet-based therapy will substitute them. How a shocking result!

Of course, this study suggested anything only in primary care setting. Specialists frequently meet clients who are much more difficult to cure. In other words, they should concentrate their power in severe and complicated patients. It seems rational. The fact that depressive patients in primary care got able to be treated by less intensive means is attributable to the endeavor of specialists developed such techniques.

In the near future, mild depression will be treatable with a computer program, or an iPhone app. I am not sure such an easy-to-treat disease will be called a mental disorder then.

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