The effectiveness of psychological treatments for treatment-resistant depression: a systematic review

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McPherson S, Cairns P, Carlyle J, Shapiro DA, Richardson P, Taylor D. The effectiveness of psychological treatments for treatment-resistant depression: a systematic review.

Acta Psychiatr Scand 2005: 1–10. © Blackwell Munksgaard 2005. Objective: 

A systematic review of all studies (controlled and uncontrolled) to evaluate psychological interventions with treatment-resistant depression. Method: 

A systematic search to identify studies evaluating a psychological intervention with adults with a diagnosis of major depressive disorder who had not responded to at least one course of antidepressant medication. Results: 

Twelve studies met inclusion criteria, of which four were controlled and eight uncontrolled. Treatment effect sizes were computable for four studies and ranged from 1.23 to 3.10 with a number of better quality studies demonstrating some improvements in patients following a psychological intervention. Conclusion: 

Psychological treatments for depression are commonly delivered and often recommended following the failure of medication. The paucity of evidence for their effectiveness in these situations is a significant problem. There is a need for studies with a strong controlled design investigating the effectiveness of psychological treatments for patients with treatment-resistant depression.

Keywords: chronic illness; depressive disorder; psychotherapy; treatment effectiveness

Document Type: Research Article


Affiliations: Psychotherapy Evaluation Research Unit, Tavistock Centre, London

Publication date: May 1, 2005

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