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The discovery that the tricyclics can help with some depressions has also brought sharper focus on the nature of depression itself and suggested better ways of dealing with it. This is essentially what Number 26 of the American Psychiatric Press series, “Progress in Psychiatry,” is all about. Its title gives its contents.
In a short introduction, the older ways of dealing with depression are shown to have some connection with what is being tried today. In Chapter 1, the editors of the book, Manning and Frances, analyze 17 studies published since 1960 and identify six as cognitive, four each as behavioral or interpersonal, two as psychoanalytic, and one as marital. Each is an attempt to reach the individual and his or her experience as a person. A pharmacological addition may also be used, usually imipramine or amitriptyline. The authors conclude, with some hesitation and consideration of exceptions, that combination therapy was not less effective than pharmacotherapy or psychotherapy alone, and call for further studies.
Three chapters follow, each essentially dealing with combined therapy. Steven D. Hollon, Robert J. DeRubeis, and Mark D. Evans, psychologists, present a comparative study between cognitive psychotherapy and imipramine, each alone and combined in treating depression. Objective measures showed the greatest improvement to occur after six weeks of treatment about equal in extent for the three modalities. Of the 64 patients completing the 12-week course of treatment, three attempted suicide, two having taken imipramine alone, one succeeding, and one on combined therapy, also succeeding. Of nine who showed serious consequences, seven were being treated with imipramine alone and one on combined therapy. As concerns the rate of relapse following the discontinuance of all specific therapy, the lowest was in the group on cognitive therapy and imipramine, and next lowest on cognitive therapy alone. Whether the subsequent and later appearance of depression in thos