It is time to investigate integrative approaches to enhance treatment outcomes for depression?

Psychological and pharmacological interventions are the most common treatments for adult depression. While these interventions have robust evidence supporting their efficacy, there remain up to 60 percent of individuals who do not respond to treatment, or only partially respond. Unfortunately, efforts at improving outcome rates from new or modified versions of psychological or pharmacological interventions have been disappointing. It is argued that increased treatment efficacy for depression may be achieved by utilising integrative or adjunctive treatments. As depression is influenced by an array of psychological, biological, social, environmental, dietary, and lifestyle factors, it is hypothesised that treatment outcomes will only be improved when integrative interventions are utilised. The research supporting the potential of several of these factors are reviewed in this article including those associated with diet, exercise, sleep, sunshine/light, nature, herbs and nutraceuticals, social connections, meditation, religion/spirituality, and alcohol and nicotine use. It is argued that increased efforts should be directed at investigating integrative or adjunctive interventions, rather than stand-alone treatments, to enhance outcomes for depression.