Study: Cognitive-behavioral therapy and SSRIs for depression both improve quality of life

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Recently published research has found that treatments for depression don’t just reduce symptoms, they are also associated with moderate improvements in quality of life.

The study, published in the journal Cognitive Behaviour Therapy, examined the two primary treatments for depression — cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs).

“Contemporary treatments are greatly focused on symptom reduction and reducing suffering,” explained Stefan G. Hofmann of Boston University, the study’s corresponding author. “Although this is an important immediate goal, a treatment will also need to enhance a patient’s quality of life to be effective in the long term. Therapy should not also make you feel less miserable, it should also make you feel better.”

Using a statistical technique known as a meta-analysis, the researchers examined data from 6,255 patients who participated in past studies examining CBT and SSRI treatment. They found that quality of life significantly improved after both SSRIs and CBT for depression.

“Overall, CBT and pharmacotherapy (SSRI treatment), which are the two most common treatments for depression, are both moderately effective for improving quality of life in the short term (from before to immediately after treatment), but probably because of a different mechanism,” Hofmann told PsyPost.

“The mechanism might be different, because the improvement in quality of life was associated with symptom improvement only in patients who received CBT, but not in those who received SSRIs. The improvements in quality of life remained relatively stable for CBT, but not enough data exist to say anything about the long-term effect of SSRIs. These results suggest our existing treatments need to be improved in order to change people’s lives for the better.”

Individual, group, and computer-based CBT for depression all had similar effects on quality of life.

However, the researchers were unable to directly compare CBT with SSRIs because of methodological issues with the previous studies. Though both treatments appeared to have similar effects on quality of life, the researchers were forced to stop short of concluding they were equally effective.

Quality of life refers to the general well-being of an individual, but Hofmann said the concept can be difficult to scientifically evaluate.

“The main caveat is the way quality of life is assessed. We used widely used standard self-report measures. However, the construct itself (QoL) is very difficult to define and even more difficult to measure,” he explained.

“Positive affect and happiness is related to this construct,” Hofmann added. “Future studies need to specifically develop treatments that enhance those aspects. My research team has been doing this by using mindfulness strategies and loving kindness and compassion meditation in treatment to enhance positive affect. The results have been very promising, see: https://www.ncbi.nlm.nih.gov/pubmed/26136807.”

“For more information about my current research, see http://bostonanxiety.org/currentresearch.html.”

The study, “Effect of treatments for depression on quality of life: a meta-analysis“, was also co-authored by Joshua Curtiss, Joseph K. Carpenter and Shelley Kind. It was published online online April 25, 2017.

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