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Does problem-solving treatment work through resolving problems?

Laurence Mynors-Wallis¹

¹Department of Psychiatry, Dorset Healthcare NHS Trust, Alderney Community Hospital, Poole.

Psychological Medicine

|November 8, 2002

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Problem-solving treatment for major depressive disorder showed no difference in efficacy compared to antidepressant medication. It also did not improve problem resolution or patient mastery and self-control more than medication.

Area of Science:

Psychiatry
Clinical Psychology
Behavioral Science

Background:

A randomized controlled trial compared problem-solving treatment (PST), antidepressant medication (ADM), and combined treatment for major depressive disorder (MDD) in primary care.
No significant differences in treatment efficacy were found among the groups for MDD.
The study also investigated potential mechanisms of action for PST.

Purpose of the Study:

To evaluate if problem-solving treatment (PST) improves major depressive disorder (MDD) by achieving greater problem resolution compared to antidepressant medication (ADM).
To determine if PST enhances patients' sense of mastery and self-control more effectively than ADM in treating MDD.

Main Methods:

A randomized controlled trial design was employed.

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Problem-solving treatment was compared against antidepressant medication.

Outcomes assessed included problem resolution and patients' sense of mastery and self-control.

Main Results:

Problem-solving treatment did not lead to significantly greater problem resolution compared to antidepressant medication.
PST did not result in a significantly greater sense of mastery or self-control in patients when compared to ADM.
No difference in treatment efficacy was observed between PST and ADM for major depressive disorders.

Conclusions:

The study's findings do not support the hypothesis that problem-solving treatment is superior to antidepressant medication in achieving problem resolution for major depressive disorder.
The results also do not support the hypothesis that problem-solving treatment enhances patients' sense of mastery and self-control more than antidepressant medication.
Problem-solving treatment's mechanisms of action, specifically problem resolution and increased mastery/self-control, were not supported as superior to antidepressant medication in this trial.