Add-On Behavioral Activation Therapy Tested

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FROM THE ANNUAL MEETING OF THE NEW CLINICAL DRUG EVALUATION UNIT

BOCA RATON, FLA. - Work, relationships, and health status can remain impaired in people even after medication successfully treats their depressive symptoms. But there is hope.

Addition of behavioral activation therapy improves the social aspects of depression, according to a small pilot study. Just 12 weeks of this therapy was enough to motivate and mobilize patients, an essential step in clinical improvement, Dr. David J. Hellerstein said at the meeting, sponsored by the National Institute of Mental Health.

Dr. Hellerstein and his colleagues treated 17 patients with Dysthymic disorder or major depression using antidepressants combined with 12 weeks of behavioral activation therapy adapted to specifically improve social function. Behavioral activation therapy is a form of cognitive-behavioral therapy (CBT) that seeks to alleviate depression by promoting a person's contact with sources of reward through increasing activation, improving problem solving, and decreasing avoidance and other barriers to activation (Curr. Psychiatry Rep. 2009;11:453-8).

All physician- and patient-rated depression scales improved with this combination approach. "Even in this small sample size, we showed improvement in the Hamilton Depression Rating Scale (HAM-D) and the Beck Depression Inventory, and the Cornell Dysthymia Rating Scale," he said in an interview.

"Medicine is the first step, [but they] must start to function again/' said Dr. Hellerstein of the department of clinical psychiatry at Columbia University, New York. "About one-third to one-half of people with chronic depression respond to medication, but don't get better psychosocially."

At baseline, participants responded to medication with a HAM-D score of 10 or depresless. …