The Impact of Psychotherapy, Pharmacotherapy, and Their... : Harvard Review of Psychiatry (original) (raw)

REVIEW

The Impact of Psychotherapy, Pharmacotherapy, and Their Combination on Quality of Life in Depression

IsHak, Waguih William MD, FAPA1; Ha, Khanh MD1; Kapitanski, Nina MD1; Bagot, Kara MD1; Fathy, Hassan MD1; Swanson, Brian PhD1; Vilhauer, Jennice PhD1; Balayan, Konstantin MD1; Bolotaulo, Nestor Ian MD1; Rapaport, Mark Hyman MD1

1_From the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine (Drs. IsHak, Vilhauer, and Rapaport); Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, Los Angeles, CA (Drs. IsHak, Ha, Vilhauer, Balayan, Bototaulo, and Rapaport, and Mr. Swanson); Departments of Psychiatry, Stanford University School of Medicine (Dr. Kapitanski), Yale University School of Medicine (Dr. Bagot), and State University of New York Downstate Medical Center (Dr. Fathy)._

Supported by a Young Investigator Award (Dr. IsHak) from the National Alliance for Research on Schizophrenia and Depression.

Correspondence: Waguih William IsHak, MD, FAPA, Cedars-Sinai Medical Center, Department of Psychiatry and Behavioral Neurosciences, 8730 Alden Dr., Suite W-101, Los Angeles, CA 90048. Email: E-mail:[email protected]

Original manuscript received March 15, 2011; revised manuscript received August 5, 2011, accepted for publication September 3, 2011.

Declaration of interest: Dr. IsHak has received research support from the National Alliance for Research on Schizophrenia and Depression (Quality of Life in Major Depression) and from Pfizer (Geodon in Major Depression). Dr. Rapaport has also received research support from NARSAD, served as a consultant to Affectis Pharmaceutics, Astellas Pharma US, Brain Cells, Dainippon Sumitomo Pharma, Johnson & Johnson, Methylation Sciences, PAX Pharmaceuticals, Quintiles/AstraZeneca, Takeda Pharmaceutical, and Wyeth.

Abstract

Background:

Quality of life (QOL) is known to be negatively affected during the course of major depressive disorder. Various studies have documented the benefits of pharmacotherapy or psychotherapy alone on QOL in depression, with few studies examining combined treatment. This review will examine the evidence for the impact of each modality, as well as their combination, on QOL in depression.

Methods:

Using the key terms depression, depress*, major depress*, quality of life, antidepressant*, and psychotherapy, MEDLINE and PsycINFO searches were conducted to identify treatment-outcome studies that used known QOL measurements over the past twenty-six years (1984 to 2010).

Results:

Significant improvements in depressive symptomatology and QOL measurements were found with pharmacotherapy, psychotherapy, and their combination, with some studies showing greater improvement following combined treatment than with either intervention alone.

Conclusions:

Substantial evidence suggests that psychotherapy, pharmacotherapy, and their combination have favorable effects on QOL in depression. While some studies have shown that combined therapy is superior than either of the two forms alone in improving QOL, additional research is needed to elucidate this effect. QOL measurement is an important dimension of treatment-outcome assessment in patients with depression.