Combined psychotherapy and pharmacotherapy for depression. A systematic analysis of the evidence

To determine whether combined psychotherapy and pharmacotherapy is superior to alternative therapies for unipolar depression, we reviewed all controlled studies of outpatients treated for unipolar depression reported between 1974 and 1984. To accomplish this, we developed a new statistical approach that is specific in its method of evaluating the quality of each study and specific about the weights given to each outcome. The combined active treatments (drugs plus psychotherapy) were appreciably more effective than the placebo conditions but only slightly superior to psychotherapy alone, pharmacotherapy alone, or either of these combined with a placebo.