1. DEPRESSION AND FAMILY RELATIONSHIPS

2. RELATIVES’ CRITICAL COMMENTS AND RELAPSE OF DEPRESSION
CRITICAL % RELAPSE P
STUDY COMMENTS
VAUGHN &
LEFF (1976)
HOOLEY (1985)
OKASHA et al (1994)

3. THE LONDON DEPRESSION INTERVENTION TRIAL
A RANDOMISED CONTROLLED TRIAL OF ANTIDEPRESSANTS VERSUS COUPLE THERAPY
THE MAIN PROBLEM WITH DEPRESSION IS NOT IMPROVING THE SYMPTOMS BUT PREVENTING RELAPSE
1 YEAR OF TREATMENT, THEN A SECOND YEAR WITH NO TREATMENT
SUBJECTS: DEPRESSED PERSON LIVING WITH A CRITICAL PARTNER (AVERAGE 8 CRITICAL COMMENTS)

4. THE LONDON DEPRESSION INTERVENTION TRIAL
ANTIDEPRESSANT (DESIPRAMINE OR FLUOXETINE) 37 PATIENTS
COUPLE THERAPY SESSIONS PATIENTS

5. THE LONDON DEPRESSION INTERVENTION TRIAL
ANTIDEPRESSANT (DESIPRAMINE OR FLUOXETINE) 37 PATIENTS
COUPLE THERAPY SESSIONS PATIENTS

6. COUPLE THERAPY 1. DEFINING PROBLEMS AND TRYING NEW SOLUTIONS
2. EXAMINING LONG-TERM RELATIONSHIP PATTERNS
3. PREVENTING RELAPSE BY ANTICIPATING LIKELY CRISIS POINTS

7. DROP-OUTS FROM TRIAL ANTI-DEPRESSANT COUPLE THERAPY PRE-TREAT. 24%
7.5%
<6 SESSIONS
22% 5%
6+ SESSIONS
11%
2.5%
TOTAL
57%
15%

9. CONCLUSIONS FROM TRIAL
FOR DEPRESSED PATIENTS LIVING WITH A CRITICAL PARTNER
COUPLE THERAPY IS MORE EFFECTIVE THAN ANTIDEPRESSANTS FOR TREATING DEPRESSION AND PREVENTING RELAPSE
COUPLE THERAPY IS MORE ACCEPTABLE TO PATIENTS THAN ANTIDEPRESSANTS

10. CONCLUSIONS FROM TRIAL
AN ECONOMIC ANALYSIS SHOWED THAT A COURSE OF COUPLE THERAPY COST NO MORE THAN A COURSE OF ANTIDEPRESSANTS

11. UK GOVERNMENT ANOUNCES BIGGEST RISE IN ANTIDEPRESSANT PRESCRIPTIONS EVER
MILLION
MILLION