Research indicates that combination of psychotherapy and antidepressant medication (ADM) provides cumulative effects and thus outperforms monotherapy in treating chronic depression. In this quasi-experimental study, we explored symptom change for patients with chronic depression treated with ADM when presenting for a 12-week psychotherapeutic inpatient treatment programme. We compared outcomes through treatment and follow-up of patients who continued medication with those who discontinued. We also tested possible moderator effects of initial depression severity on change between the groups. Based on prior research, we hypothesized that combination treatment would yield better results (i.e., more reduction in depression). Patients (N = 112) were referred from general practitioners or local secondary health care. Outcome was measured by Beck Depression Inventory-II (BDI-II), and comparisons were carried out using multilevel modelling. Although 35 patients discontinued ADM during treatment, 77 continued. Both continuers and discontinuers had a significant treatment effect that was maintained at 1-year follow-up. There was no difference in outcome between continuers and discontinuers of ADM. Patients with severe depression had significantly more symptom improvement than patients with moderate depression, but depression severity did not affect outcomes across continuers and discontinuers of ADM differently. The results could indicate that patients had developed resistance and/or tolerance to the prophylactic effects of medication and that ADM did not contribute to the reduction of depressive symptoms. The findings may also indicate that psychotherapy alone in some instances can be a viable alternative to continued combined treatment. Clinicians should carefully assess benefits of patients' ongoing use of antidepressant medication when entering psychotherapy.

中文翻译：

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比较住院心理治疗后慢性抑郁症患者继续服用抗抑郁药与停止服用抗抑郁药的结果

研究表明，心理疗法和抗抑郁药物 (ADM) 的组合提供累积效应，因此在治疗慢性抑郁症方面优于单一疗法。在这项准实验性研究中，我们探讨了接受 ADM 治疗的慢性抑郁症患者在接受为期 12 周的心理治疗住院治疗计划时的症状变化。我们通过对继续服药的患者和停药的患者的治疗和随访来比较结果。我们还测试了初始抑郁严重程度对组间变化的可能调节作用。根据先前的研究，我们假设联合治疗会产生更好的结果（即抑郁症的减少更多）。患者 ( N = 112) 是从全科医生或当地二级医疗保健机构转介的。结果由贝克抑郁量表-II (BDI-II) 测量，并使用多级建模进行比较。尽管 35 名患者在治疗期间停止了 ADM，但仍有 77 名患者继续服用。继续者和中断者都具有显着的治疗效果，并在 1 年的随访中得以维持。ADM 的继续者和终止者之间的结果没有差异。重度抑郁症患者的症状改善明显多于中度抑郁症患者，但抑郁症的严重程度不会以不同的方式影响 ADM 继续者和终止者的结果。结果可能表明，患者对药物的预防作用产生了抵抗力和/或耐受性，并且 ADM 无助于减轻抑郁症状。研究结果也可能表明，在某些情况下，单独的心理治疗可能是持续联合治疗的可行替代方案。临床医生应仔细评估患者在接受心理治疗时持续使用抗抑郁药物的益处。