Effekten av psykoterapi for mennesker med depressive lidelser

Abstract

In October 2008, the Norwegian Directorate of Health commissioned the Norwegian Knowledge Centre for the Health Services (NOKC) to complete a review about the effects of psychotherapy for adults with depression. The review would help answer the question of how adults with depression should be best managed. We addressed one main question: What are the effects of psychotherapy on depression symptomatology and quality of life indicators for adults with depression?

We searched systematically for relevant literature in international scientific databases. We evaluated newly published systematic reviews and randomized controlled trials (RCTs) for inclusion using a pre-designed inclusion form. We then appraised the methodological quality of the included studies with appropriate check lists, and summarised the results in tables and text. In accordance with the commissioner's requests, we gave emphasis to findings from the systematic reviews and results related to psychodynamic psychotherapy.

We included and summarised results from a total of nine studies; six systematic reviews and three RCTs. The great majority of the studies were of high methodological quality. Study results show that patients significantly improved post-treatment. Findings suggest that psychotherapy is effective in reducing patients' depression symptomatology compared to treatment as usual. Improvements in depression symtomatology and social functioning appear to be modest, improvements are similar to those observed for psychopharmacological treatments, and no psychotherapy technique appears to be superior. Psychodynamic psychotherapy does not seem to cause greater improvements in depression symptomatology compared to other types of psychotherapy.

Based on the best available evidence, it appears that psychotherapy improves depression symptomatology in adults with depressive illnesses. However, the literature search was restricted and the evidence base for the current review was heterogeneous, thus the results must be viewed as tentative.