Research on Effects of Psychotherapies and Pharmacotherapies

Question 1

A network meta-analysis of the efects of psychotheraies, pharmacotherapies, and their combination in the treatment of adult depression (Cuipers, et al., 2020)

Answer 1

1. Combined treatment was more effective than psychotherapy or pharmacotherapy alone in the short term treatment of moderate depression AND there are no significant differences between psychotherapy and pharmacotherapy.
2. This pattern is also true in chronic and treatment resistant depression AND also likely for severe depression.
3. The findings suggest that guidelines should recommend combined treatment as the first option in the treatment of depression AND because of higher acceptability may recommend psychotherapy before pharmacotherapy depending on the patient preference.

Question 2

Evidence-based psychotherapies for bipolar disorder Novick & Swartz, 2019).

Answer 2

1. side note- pharmacotherapy is the first line of treatment for bipolar disorder in ALL PHASES.
2. Novick & Swartz discuss the benefits of adjunctive therapies.a. Psychoeducation- promote understanding of the illness, prodromal symptoms, and triggers; develop concrete strategies
   b. CBT- promote understanding of illness and informed treatment decision making
   c. Family focused therapy- Promote understanding of illness, vulnerability-stress model, and patient’s inner experience. Strengthen family’s ability to resolve stressful situations.
   d. Interpersonal and social rhythm therapy- Complete a focused clinical and interpersonal history, link mood and life events, foster grief for loss of healthy self, develop and maintain daily regular social rhythms
   e. Peer support.

Question 3

Adjunctive psychotherapy for bipolar disorder0 JAMA article (Miklowitz et al., 2020).

Answer 3

1. Manualized psychotherapy is associated with reduced recurrences compared with pharmacotherapy and treatment as usual.
2. Family, conjoint, CBT, and psychoeducation focus on active skill training lowers recurrences compared to treatment as usual.
3. Family/conjoint therapy and psychoeducation were associated with lower attrition than psychoeducation alone.
4. CBT, IPSRT, and family/conjoint therapy have similar outcomes for depression stabilization.
5. For manic phase- no evidence that cognitive restructuring is helpful. Psychoeducation, CBT and IPSRT are helpful in manic phases (specifically behavioral techniques)>