"Coping with depression": an open study of the efficacy of a group psychoeducational intervention in chronic, treatment-refractory depression. Psychoeducation efficacy in bipolar disorders: beyond compliance enhancement. [The effectiveness of psychoeducation in schizophrenic and depressive patients--preliminary report]. A randomized trial on the efficacy of group psychoeducation in the prophylaxis of recurrences in bipolar patients whose disease is in remission. Efficacy of a dilemma-focused intervention for unipolar depression: study protocol for a multicenter randomized controlled trial Prevention of depressive symptoms through the use of distance technologies. Treatment preference, engagement, and clinical improvement in pharmacotherapy versus psychotherapy for depression. Rational-emotive and cognitive-behavior therapy (REBT/CBT) versus pharmacotherapy versus REBT/CBT plus pharmacotherapy in the treatment of major depressive disorder in youth; A randomized clinical trial A psychoeducational approach to the treatment of depression: comparison of group, individual, and minimal contact procedures. Efficacy of an adjunctive brief psychodynamic psychotherapy to usual inpatient treatment of depression: rationale and design of a randomized controlled trial Improving outpatient care of depression by implementing practice guidelines: a controlled clinical trial. Resolving Disparities in Antidepressant Treatment and Quality-of-Life Outcomes Between Uninsured and Insured Primary Care Patients With Depression Continuity is the main challenge in treating major depressive disorder in psychiatric care. A three-country randomized controlled trial of a psychosocial intervention for caregivers combined with pharmacological treatment for patients with Alzheimer disease: effects on caregiver depression. A target-driven collaborative care model for Major Depressive Disorder is effective in primary care in the Netherlands. A randomized clinical trial from the depression initiative. Inpatient psychotherapeutic treatment for cardiac patients with depression in Germany - short term results A randomized controlled trial of a psychoeducational group program for unipolar depression in adults in Norway (NCT00319540)
BACKGROUND Failure to respond to antidepressant medication represents a major clinical problem . Few therapeutic interventions have been shown to benefit such individuals . METHOD Patients attended a 12-session psychoeducational programme over a period of 10 weeks , with follow-up at 26 weeks . The main outcome measures were the self-report Beck Depression Inventory ( BDI-II ) , the Global Severity Index ( GSI ) of the Brief Symptom Inventory ( BSI ) and the EuroQol 5D . RESULTS Baseline assessment s confirmed substantial chronicity and treatment resistance , high symptom burden and poor quality of life in the study cohort . Twenty-six week follow-up data were obtained from 34 % of cohort . Completion of the course was associated with clinical ly significant changes in symptom burden . Sustained remission was achieved by 35 % of completers . LIMITATIONS We did not characterise the cohort using structured clinical interview and did not collect structured , objective ratings of mental health status . There was no control group . There was a high attrition rate and caution must be exercised in interpreting results . CONCLUSIONS For a proportion of patients with chronic depressive episodes that have not responded to  antidepressant treatments  , the " Coping with Depression " psychoeducational group may confer sustained and meaningful benefit . Controlled studies are warranted BACKGROUND Several previous studies have established that low treatment adherence is common among bipolar patients and may explain high rates of recurrence . On the other h and , some patients keep relapsing even when they strictly follow their prescribed somatic treatments . Psychological interventions such as psychoeducation may foster early recognition of prodromal symptoms and minimize the risk of relapse . To date , studies assessing the usefulness of psychoeducation in fully compliant patients are lacking . METHOD This was a single-blind , r and omized , prospect i ve clinical trial on the efficacy of group psychoeducation in remitted fully compliant DSM-IV bipolar I patients ( N = 25 ) who were compared with a group with similar characteristics ( N = 25 ) who did not receive psychoeducation .  All patients received naturalistic pharmacologic treatment . Recruitment began in 1997 and follow-up was completed in January 2002 . The follow-up phase comprised 2 years during which all patients continued receiving naturalistic treatment without psychological intervention and were assessed monthly on several outcome measures . RESULTS At the end of the 2-year follow-up , 23 subjects ( 92 % ) in the control group fulfilled criteria for recurrence versus 15 patients ( 60 % ) in the psychoeducation group ( p < .01 ) . The number of total recurrences and the number of depressive episodes were significantly lower in psychoeducated patients . CONCLUSION Although the present study has the limitation of small sample size , psychoeducation showed its efficacy in preventing relapses in bipolar I patients who were adherent to drug treatment . The action of psychoeducation seems to go beyond compliance enhancement and may support a tripod model composed by lifestyle regularity and healthy habits , early detection of prodromal signs followed by prompt drug intervention , and finally treatment compliance UNLABELLED Earlier studies suggest that psychoeducation as a form of psychosocial care is of value in improving the patient 's attitude towards mental illness as well as in reducing and delaying the relapse rates of both -- psychotic and depressive disorders . AIM The aim of this study was the evaluation of influence of psychoeducation on clinical symptoms , quality of life and drug attitude in schizophrenic and depressive patients . METHOD 52 patients , aged 18 - 50 years , hospitalized in the Department of Psychiatry of Medical Academy in Białystok , were involved in the study . They were r and omly assigned into 2 groups : on medication without psychoeducation ( 12 schizophrenics , 12 depressive patients ) and on medication and psychoeducation ( 16 schizophrenics and 12 depressive patients ) . The patients were assessed by means of BPRS , BNS , IMHC 2000 , Raskin/Covi Scale , DAI-10 . The assessment was performed twice -- shortly after admission and before discharge from the hospital . RESULTS The patients in both groups showed improvement in symptoms and in quality of life . Patients on psychoeducation changed their drug attitude positively significantly more often . CONCLUSION Knowledge about the positive influence of medication on psychiatric symptoms helps to improve compliance and improves the course of disease BACKGROUND Studies on individual psychotherapy indicate that some interventions may reduce the number of recurrences in bipolar patients . However , there has been a lack of structured , well- design ed , blinded , controlled studies demonstrating the efficacy of group psychoeducation to prevent recurrences in patients with bipolar I and II disorder . METHODS One hundred twenty bipolar I and II out patients in remission ( Young Mania Rating Scale score < 6 , Hamilton Depression Rating Scale-17 score < 8) for at least 6 months prior to inclusion in the study , who were receiving st and ard pharmacologic treatment , were included in a controlled trial . Subjects were matched for age and sex and r and omized to receive , in addition to st and ard psychiatric care , 21 sessions of group psychoeducation or 21 sessions of nonstructured group meetings . Subjects were assessed monthly during the 21-week treatment period and throughout the 2-year follow-up . RESULTS Group psychoeducation significantly reduced the number of relapsed patients and the number of recurrences per patient , and increased the time to depressive , manic , hypomanic , and mixed recurrences . The number and length of hospitalizations per patient were also lower in patients who received psychoeducation . CONCLUSION Group psychoeducation is an efficacious intervention to prevent recurrence in pharmacologically treated patients with bipolar I and II disorder Background Depression is one of the more severe and serious health problems because of its morbidity , disabling effects and for its societal and economic burden . Despite the variety of existing pharmacological and psychological treatments , most of the cases evolve with only partial remission , relapse and recurrence . Cognitive models have contributed significantly to the underst and ing of unipolar depression and its psychological treatment . However , success is only partial and many authors affirm the need to improve those models and also the treatment programs derived from them . One of the issues that requires further elaboration is the difficulty these patients experience in responding to treatment and in maintaining therapeutic gains across time without relapse or recurrence . Our research group has been working on the notion of cognitive conflict viewed as personal dilemmas according to personal construct theory . We use a novel method for identifying those conflicts using the repertory grid technique ( RGT ) . Preliminary results with depressive patients show that about 90 % of them have one or more of those conflicts . This fact might explain the blockage and the difficult progress of these patients , especially the more severe and /or chronic . These results justify the need for specific interventions focused on the resolution of these internal conflicts . This study aims to empirically test the hypothesis that an intervention focused on the dilemma(s ) specifically detected for each patient will enhance the efficacy of cognitive behavioral therapy ( CBT ) for depression . Design A therapy manual for a dilemma-focused intervention will be tested using a r and omized clinical trial by comparing the outcome of two treatment conditions : combined group CBT ( eight , 2-hour weekly sessions ) plus individual dilemma-focused therapy ( eight , 1-hour weekly sessions ) and CBT alone ( eight , 2-hour group weekly sessions plus eight , 1-hour individual weekly sessions ) . Method Participants are patients aged over 18 years meeting diagnostic criteria for major depressive disorder or dysthymic disorder , with a score of 19 or above on the Beck depression inventory , second edition ( BDI-II ) and presenting at least one cognitive conflict ( implicative dilemma or dilemmatic construct ) as assessed using the RGT . The BDI-II is the primary outcome measure , collected at baseline , at the end of therapy , and at 3- and 12-month follow-up ; other secondary measures are also used . Discussion We expect that adding a dilemma-focused intervention to CBT will increase the efficacy of one of the more prestigious therapies for depression , thus result ing in a significant contribution to the psychological treatment of depression . Trial registration IS RCT N92443999 ; Clinical Trials.gov Identifier : NCT01542957 Psychoeducational material s can be disseminated at minimal expense through the use of distance technologies , offering an opportunity for prevention . The objective of this project was to develop and evaluate a psychoeducational computer program design ed to prevent depressive symptoms . The program was accessible through the Internet or by touch-tone telephone . A total of 786 participants were r and omly assigned either to the preventive intervention or to an information-only control condition . Over a three-month follow-up period , no differences between the groups were observed . However , three of the target variables ( cognitive style , activity level , and sleep quality ) were found to be strong predictors of whether a participant had an episode of major depression during the follow-up period Pharmacotherapy and psychotherapy are generally effective treatments for major depressive disorder ( MDD ) ; however , research suggests that patient preferences may influence outcomes . We examined the effects of treatment preference on attrition , therapeutic alliance , and change in depressive severity in a longitudinal r and omized clinical trial comparing pharmacotherapy and psychotherapy . Prior to r and omization , 106 individuals with MDD reported whether they preferred psychotherapy , antidepressant medication , or had no preference .  A mismatch between preferred and actual treatment was associated with greater likelihood of attrition , fewer expected visits attended , and a less positive working alliance at session 2 . There was a significant indirect effect of preference match on depression outcomes , primarily via effects of attendance . These findings highlight the importance of addressing patient preferences , particularly in regard to patient engagement , in the treatment of MDD Major depressive disorder is a highly prevalent and debilitating condition in youth , so developing efficient treatments is a priority for mental health professionals . Psychotherapy ( i.e. , cognitive behavioral therapy/CBT ) , pharmacotherapy ( i.e. , SSRI medication ) , and their combination have been shown to be effective in treating youth depression ; however , the results are still mixed and there are few studies engaging multi-level analyses ( i.e. , subjective , cognitive , and biological ) . Therefore , the aims of this r and omized control study ( RCT ) were both theoretical - integrating psychological and biological markers of depression in a multi-level outcome analysis - and practical - testing the generalizability of previous results on depressed Romanian youth population . Eighty-eight ( N=88 ) depressed Romanian youths were r and omly allocated to one of the three treatment arms : group Rational Emotive Behavior Therapy (REBT)/CBT ( i.e. , a form of CBT ) , pharmacotherapy ( i.e. , sertraline ) , and group REBT/CBT plus pharmacotherapy . The results showed that all outcomes ( i.e. , subjective , cognitive , and biological ) significantly change from pre to post-treatment under all treatment conditions at a similar rate and there were no significant differences among conditions at post-test . In case of categorical analysis of the clinical response rate , we found a non-significant trend favoring group REBT/CBT therapy . Results of analyses concerning outcome interrelations are discussed This study examined the efficacy of a psychoeducational approach in treating unipolar depression . The vehicle of treatment was a course in " Coping with Depression . " An explicit educational experience , the course addressed several specific target behaviors ( social skills , thinking , pleasant activities , and relaxation ) as well as more general components hypothesized to be critical to successful cognitive-behavioral therapy for depression . Sixty-three individuals who met Research Diagnostic Criteria ( RDC ) for unipolar depression were r and omly assigned to one of four conditions : class , individual tutoring , minimal contact , or delayed treatment control . Participants in the immediate treatment conditions were assessed pre- and posttreatment and at 1- and 6-month follow-up sessions ; the delayed treatment group was assessed prior to and following an 8-week waiting period . Results indicated clinical improvement by all of the active treatment conditions compared to the delayed treatment condition . Differences between active treatment conditions were small , and some differences between high and low responders to treatment were found . Results are discussed in terms of their implication s for future clinical use of this approach . Stimulated by recent theoretical developments , there has been an impressive proliferation of interventions and approaches for the psychological treatment of unipolar depression . Treatments derived from cognitive positions have been aim ed at depressive thought processes ( e.g. , Beck , Rush , Shaw , & Emery , 1979 ; Fuchs & Rehm , 1977 ) , whereas those derived from behavioral positions have been aim ed at the improvement of social skills ( Hersen , Bellack , & Himmelhoch , 1980 ; Sanchez , Lewinsohn , & Larson , 1980 ; Zeiss , 1977 ) , at increasing pleasant activities and time management relaxation skills ( Lewinsohn , 1977 ) , and at more general problemsolving skills ( McLean & Hakstian , 1979 ) . Background A few recent studies have found indications of the effectiveness of  inpatient psychotherapy  for depression , usually of an extended duration . However , there is a lack of controlled studies in this area and to date no study of adequate quality on brief psychodynamic psychotherapy for depression during short inpatient stay exists . The present article describes the protocol of a study that will examine the relative efficacy , the cost-effectiveness and the cost-utility of adding an Inpatient Brief Psychodynamic Psychotherapy to pharmacotherapy and treatment-as-usual for in patients with unipolar depression . Methods / Design The study is a one-month r and omized controlled trial with a two parallel group design and a 12-month naturalistic follow-up . A sample of 130 consecutive adult in patients with unipolar depression and Montgomery-Asberg Depression Rating Scale score over 18 will be recruited . The study is carried out in the university hospital section for mood disorders in Lausanne , Switzerl and . Patients are assessed upon admission , and at 1- , 3- and 12- month follow-ups . Inpatient therapy is a manualized brief intervention , combining the virtues of inpatient setting and of time-limited dynamic therapies ( focal orientation , fixed duration , re source -oriented interventions ) . Treatment-as-usual represents the best level of practice for a minimal treatment condition usually proposed to in patients . Final analyses will follow an intention – to-treat strategy . Depressive symptomatology is the primary outcome and secondary outcome includes measures of psychiatric symptomatology , psychosocial role functioning , and psychodynamic-emotional functioning . The mediating role of the therapeutic alliance is also examined . Allocation to treatment groups uses a stratified block r and omization method with permuted block . To guarantee allocation concealment , r and omization is done by an independent research er . Discussion Despite the large number of studies on treatment of depression , there is a clear lack of controlled research in inpatient psychotherapy during the acute phase of a major depressive episode . Research on brief therapy is important to take into account current short lengths of stay in psychiatry . The current study has the potential to scientifically inform appropriate inpatient treatment . This study is the first to address the issue of the economic evaluation of inpatient psychotherapy . Trial registration Australian New Zeal and Clinical Trial Registry ( ACTRN12612000909820 OBJECTIVE Depressive disorders are of great medical and political significance . Although evidence -based guidelines have been published and educational initiatives have been launched to implement them , they are rarely actually used . The aim of the study was to implement clinical practice guidelines for outpatient care of depression using a practice -oriented and interdisciplinary approach . DESIGN Controlled clinical trial with a naturalistic design ( data collection within routine practice ) design ed as a prospect i ve pre-post study . SETTING Outpatient care . PARTICIPANTS 29 general practitioners ( intervention : 18 ; control : 11 ) and 15 psychiatrists ( intervention : 11 ; control : 4 ) . Overall , the treatment of 698 patients ( two sample s : pre : 361 ; post : 337 ) was documented . INTERVENTION s ) Multifaceted intervention combining benchmarking , continuous medical education and interdisciplinary quality circles for the diagnosis and treatment of depressive disorders . MAIN OUTCOME MEASURES Mixed-effects regression models for cluster-adjusted analysis of patients ' symptom reduction . RESULTS Although physicians in the intervention group improved their clinical effectiveness ( proportion of patients with response/remission ) to a greater extent than physicians in the control group ( intervention : 48.6 % to 66.9 % ; control : 54.9 % to 61.5 % ) , cluster-adjusted analysis failed to prove a statistically significant effect of the intervention on the treatment outcome . CONCLUSIONS Although no statistically significant improvements were found regarding the outcomes , the action programme provides important work , material s and results for an integrated treatment model for depression Background .Efforts to improve primary care depression treatment should penetrate to vulnerable uninsured population s. Objective .To assess a primary care intervention ’s impact on treatment and quality -of-life outcomes in uninsured and insured depressed patients during the acute treatment phase . Research Design . Twelve community primary care practice s were r and omized  to ‘ enhanced ’ ( intervention ) and usual care conditions . Physicians , nurses and administrative staff in enhanced care practice s received training to improve detection and management of depression . Subjects . In 1996 to 1997 , 383 nonelderly depressed patients who were either uninsured or covered by private insurance/Medicaid were enrolled ; 343 ( 89.6 % ) completed six-month follow-up . Measures .Adequate  pharmacotherapy  ( ≥3 months of antidepressants at therapeutic doses ) ; adequate psychotherapy  ( ≥8 counseling visits ) ; improvement in mental-health-related- quality -of-life ( MHQOL ) , assessed by Mental Component Summary scale for SF-36 . Results .Multivariate results showed that 54.6 % of uninsured enhanced care ( UEC ) patients received adequate pharmacotherapy , compared with 14.3 % of uninsured usual care ( UUC ) patients ( P = 0.0005 ) ; however , receipt of adequate psychotherapy was comparable between these two groups ( 18.2 % UEC , 11.9 % UUC;P = 0.42 ) . Intervention effects on insured patients ’ treatment were modest to minimal . Among usual care patients , the insured had 5.4 points greater improvement in MHQOL at 6 months than the uninsured ( 12.4 points insured , 7.0 points uninsured;P = 0.02 ) ; however , among patients receiving the intervention , the insured and uninsured had comparable MHQOL improvement ( 12.3 points insured , 11.6 points uninsured;P = 0.76 ) . Conclusions .The intervention improved antidepressant treatment rates in uninsured patients and helped resolve quality -of-life outcome disparities observed between insured and uninsured patients receiving usual care OBJECTIVE Several evidence -based treatment guidelines for major depressive disorder ( MDD ) have been published . However , little is known about how recommendations for treatment are adhered to by patients in current usual psychiatric practice . METHOD The Vantaa Depression Study is a prospect i ve , naturalistic cohort study of 269 psychiatric patients with a new episode of DSM-IV MDD who were interviewed with the Schedules for Clinical Assessment in Neuropsychiatry and Structured Clinical Interview for DSM-III-R Personality Disorders between February 1 , 1997 , and May 31 , 1998 , and again at 6 and 18 months . Treatments provided , as well as adherence to and attitudes toward both antidepressants and psychotherapeutic support/psychotherapy , were investigated among the 198 unipolar patients followed for 18 months . RESULTS Most depression patients ( 88 % ) received antidepressants in the early acute phase , but about half ( 49 % ) terminated treatment prematurely . This premature termination was associated with worse outcome of major depressive episodes , and with negative attitudes , mainly explained by fear of dependence on or side effects of antidepressants . Nearly all patients ( 98 % ) received some  psychosocial treatment  in the acute phase ; about one fifth ( 16 % ) had weekly psychotherapy  during the follow-up . About a quarter of patients admitted nonadherence to ongoing treatments . CONCLUSION Problems of psychiatric care seem most related to continuity of treatment . While adequate treatments are provided in the early acute phase , antidepressants are terminated too soon in about half of patients , often following their autonomous decisions . From a secondary and tertiary preventive point of view , improving continuity of treatment would appear a crucial task for improving the outcome of psychiatric patients with MDD OBJECTIVE To evaluate the effectiveness of a combination of cholinesterase inhibitor therapy for patients with Alzheimer disease ( AD ) and psychosocial intervention  , for their spouse caregivers compared with drug treatment alone in three countries simultaneously . DESIGN R and omized controlled trial . Structured question naires were administered at baseline and at regular follow-up intervals for 24 months by independent raters blind to group assignment . SETTING Outpatient research clinics in New York City , U.S. , Manchester , U.K. and Sydney , Australia . PARTICIPANTS Volunteer sample of 158 spouse caregivers of community dwelling patients with AD . INTERVENTIONS Five sessions of individual and family counseling within 3 months of enrollment and continuous availability of ad hoc telephone counseling were provided for half the caregivers . Donepezil was prescribed for all patients . MAIN OUTCOME MEASURE Depressive symptoms of spouse caregivers measured at intake and follow-up assessment s for 24 months using Beck Depression Inventory ( revised ) . RESULTS Depression scores of caregivers who received counseling decreased over time , whereas the depression scores for caregivers who did not receive counseling increased . The benefit of the psychosocial intervention was significant after controlling for site , gender and country was not accounted for by antidepressant use and increased over 2 years even though the individual and family counseling sessions occurred in the first 3 months . CONCLUSION Effective counseling and support interventions can reduce symptoms of depression in caregivers when patients are taking donepezil . Harmonized multinational psychosocial interventions are feasible . Combined drug and supportive care approaches to the management of people with AD should be a priority BACKGROUND Practice variation in the primary care treatment of depression may be considerable in the Netherl and s , due to relatively small and unregulated practice s. We adapted the collaborative care model for the treatment of Major Depressive Disorder ( MDD ) to accommo date existing practice variation and tested whether this had added value over Care as Usual ( CAU ) . METHODS A cluster r and omized controlled trial was conducted to compare an adapted target driven collaborative care model with Care as Usual ( CAU ) .  R and omization was at the level of 18 (sub)urban primary care centers . The care manager and GP were supported by a web-based tracking and decision aid system that advised targeted treatment actions to achieve rapid response and if possible remission , and that warned the consultant psychiatrist if such treatment advice was not followed up . Eligible patients had a score of 10 or higher on the PHQ9 , and met diagnostic criteria for major depression at the subsequent MINI Neuropsychiatric interview . A total of 93 patients were identified by screening . They received either collaborative care ( CC ) or CAU .  Another 56 patients received collaborative care  after identification by the GP . The outcome measures were response to treatment ( 50 % or greater reduction of the PHQ9-total score from baseline ) at three , six , nine and twelve months , and remission ( a score of 0 - 4 on the PHQ9 at follow-up ) . RESULTS Treatment response and remission in CAU were low . Collaborative care was more effective on achieving treatment response than CAU at three months for the total group of patients who received collaborative care [ OR 5.2 ( ( 1.41 - 16.09 ) , NNT 2 ] and at nine months [ OR 5.6 ( ( 1.40 - 22.58 ) ) , NNT 3 ] . The effect was not statistically significant at 6 and 12 months . LIMITATIONS A relatively high percentage of patients ( 36.5 % ) did not return one or more follow-up question naires . There was no evidence for selective non response . CONCLUSIONS Our adapted target driven CC was considerably more effective than CAU for MDD in primary care in the Netherl and s. The Numbers Needed To Treat ( NNT ) to achieve response in one additional patient were low ( 2 - 3 ) , which suggest that introducing CC at a larger scale may be beneficial . The relatively large effects may be due to our focus on reducing practice variation through the introduction of easy to use web based tracking and decision aids . The findings are highly relevant for the application of the model in areas where practice s tend to be small and for mixed healthcare systems such as in many countries in Europe . TRIAL REGISTRATION Dutch trial register IS RCT N15266438 ( http://www.trialregister.nl/trialreg/admin/ rct view.asp?TC=820 ) The purpose of the PROTeCD(Psychotherapeutic Re source -Orientated Treatment for Cardiac Patients with Depression)- study was to develop and to evaluate a brief psychotherapeutic intervention for rehabilitation in- patients with coronary heart disease ( CHD ) and depressive disorders . In three cardiac rehabilitation hospitals all patients were screened for mental distress at admission . Patients generally stay for 3 to 4 weeks before being referred to outpatient care . Method : Those patients with elevated distress were interviewed for mental disorders and took part in the baseline- assessment . Patients diagnosed with a depressive disorder at baseline were r and omised into the intervention or the usual care group .  Efficacy was assessed at discharge from hospital ( short-term ) . 59 subjects with CHD and co-morbid depressive disorder were r and omised into the trial - 27 into the intervention group ( IG ) and 32 into the usual care group ( UC ) . Patients in the intervention group received 4 to 6 individual psychotherapeutic sessions of 50 minutes each , including patient education and cognitive-behavioural treatment of depression . Outcome measures were depressive and anxiety symptoms in self report and interview . Results : There was no significant difference between intervention and usual care group in this short-term reduction of depressive symptoms , mental distress and anxiety . However , at discharge the patients still suffer from an increased level of distress compared to the recommended cut off scores of the assessment scales . Conclusion : Multimodal inpatient rehabilitation reduces depressive and anxiety symptoms in depressed CHD patients in short term independently of an additional psychotherapeutic intervention Background Coping with  Depression Course ( CWD ) has shown to be effective in the treatment of depression . However , there are very few r and omized controlled trials on unipolar depression in adults Aims To test the effect of a modified CWD on unipolar depression in a r and omized controlled trial design in adults . Methods Participants were recruited through mass media , tested by BDI and clinical interview , and r and omized into intervention group ( N = 81 ) and control group ( N = 74 ) . The program was mainly conducted by nurses with background in psychiatry and primary health care , and the intervention encompassed 8 weekly sessions of 2 1/2 hours , with 3 booster sessions . Results By " intention-to-treat " analysis a statistically significant effect on depressive symptoms at follow up at 6 months was found , and the level of symptoms was sustained after 12 months . Conclusion The study shows that the intervention is effective in the treatment of unipolar depression , and suitable for specialized psychiatric services as well as primary health care
Conclusions : Psychoeducation is a psychosocial treatment that has been well documented as an adjunct to pharmacological therapy .
However , there are only a few studies regarding its effectiveness on adult patients with major depressive disorder .
Although the publications in this area are still very limited , the articles selected in this review suggest that psychoeducation is effective in improving the clinical course , treatment adherence , and psychosocial functioning of depressive patients
Objective : Pharmacological treatment is considered indispensable to major depressive disorder .
In spite of this , a significant number of patients do not respond adequately to treatment based only on medication , presenting high relapse and recurrence rates .
Therefore , psychosocial interventions , such as psychoeducation , have been increasingly recognized as an essential component in the treatment of depression , associated with pharmacological strategies .
Thus , the aim of the present systematic review was to evaluate the effectiveness of psychoeducation  for patients with unipolar depression , analyzing the evidence from the literature .