Multimodal therapy of treatment resistant depression: a study and analysis

To demonstrate through the use of a case study, the application of cognitive psychotherapy in the treatment of resistant depression.

The case of a woman with an 18-month history of resistant depression associated with low self-esteem, guilt and shame, who failed to respond to three therapeutic trials of anti-depressants is described. A detailed description of a CBT intervention over 12 sessions is given.

Clear improvements on assessments of mood and hopelessness, along with overall improvements in social and occupational functioning were noted.

These improvements were attributed to a combination of CBT and pharmacotherapy, where pharmacotherapy alone failed to alleviate symptoms. A concise literature review revealed relatively few published trials of psychological treatments, and a lack of clear guidelines on pharmacological treatments. More research is needed to explore the efficacy of psychological therapies for treatment resistant depression.