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Chapter 6 Depressive Disorders

Evidence Based Practices for Mental Health Professionals

By Jim Messina, Ph.D., CCMHC, NCC, DCMHS-T

LEARNING OBJECTIVES FOR

DEPRESSIVE DISORDERS

After reading this section you will learn the answers to the following questions:

  1. What are the ICD-10-CM Codes for Depressive Disorders?
  2. What are the clinical descriptors for Depressive Disorders?
  3. What are the symptoms common for Depressive Disorders?
  4. What are the common populations which are treated for Depressive Disorders?
  5. What are the common treatment settings for Depressive Disorders?
  6. What are the Evidence Based Practices for treating Depressive Disorders?
  7. What are the common psychopharmacological treatments for Depressive Disorders?
  8. What are some common manuals, guideline books and client workbooks for treating Depressive Disorders?
  9. What are some good references you can use to learn more in-depth information about Depressive Disorders?

ICD-10-CM Codes for Depressive Disorders in DSM-5

F34.8 Disruptive Mood Dysregulation Disorder

F32.0 Major Depressive Disorder, Single Episode Mild

F32.1 Major Depressive Disorder, Single Episode Moderate

F32.2 Major Depressive Disorder, Single Episode Severe

F32.3 Major Depressive Disorder, Single Episode with psychotic features

F32.4 Major Depressive Disorder, Single Episode in partial remission

F32.5 Major Depressive Disorder, Single Episode Mild in full remission

F32.0 Major Depressive Disorder, Single Episode Unspecified

F33.0 Major Depressive Disorder, Recurrent Episode Mild

F33.1 Major Depressive Disorder, Recurrent Episode Moderate

F33.2 Major Depressive Disorder, Recurrent Episode Severe

F33.3 Major Depressive Disorder, Recurrent Episode with psychotic features

F33.41 Major Depressive Disorder, Recurrent Episode in partial remission

F33.42 Major Depressive Disorder, Recurrent Episode in full remission

F34.1 Major Depressive Disorder, Recurrent Episode Unspecified

F34.1 Persistent Depressive Disorder (Dysthymia)

N94.3 Premenstrual Dysphoric Disorder


ICD-10-CM Codes for Trauma and Stressor-Related Disorders

F94.1 Reactive Attachment Disorder

F94.2 Disinhibited Social Engagement Disorder

F43.21 Adjustment Disorder with depressed mood

F43.23 Adjustment Disorder with mixed anxiety and depressed mood

F43.24 Adjustment Disorder with disturbance of conduct

F43.25 Adjustment Disorder with mixed disturbance of emotions and conduct

F43.20 Adjustment Disorder Unspecified

F43.8 Adjustment Disorder with Other Specified Trauma-and Stressor-Related Disorder

F43.9 Adjustment Disorder with Unspecified Trauma-and Stressor-Related Disorder

 

American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental disorders (5th ed.) (DSM-5). Washington, DC: Author.

Walter and Greta: Depressive Disorder


Walter and Greta came in last week to share their concerns that they both are suffering from chronic depression since their son died two years ago in the war. They say that no matter what they do, they are not able to cry themselves to sleep at night and neither of them have the same level of motivation and drive in their respective jobs in the medical field. They have tried support groups for people who have lost loved ones, but they never feel that they are experiencing resolution of the loss. They have tried work with their pastor hoping that reawaking their spiritual lives would help, but they are still stuck in the doldrums. They try not to watch TV news or read articles in the paper or magazines about the war. They have tried to keep journals, make memorial scrapbooks and photo albums of their son and the hole in their hearts is still aching with pain and sadness. They resist telling their primary care physician about their depression for fear he will prescribe them medications to help them overcome their depression. They say the reason they do not want to go on meds is that they believe medications just sedate or block their memories of the past and their sadness and once they come off the meds they will be back to where they were before they started taking the medications. They conclude: “So what do you think we should do?”


You begin by saying that it is clear that their depression is real and that it needs “real treatment” which works rather than to do things that they hope will wish it away. You tell them about the power of Cognitive Behavioral Therapy (CBT) which has a great track record to help alleviate depressive symptoms like theirs. You reassure them that CBT has been greatly researched and that if they do the homework, stay consistent in its approach which includes doing a daily journal that they will be successful in lessening if not ridding themselves of the depression. You tell them if after six months of about 12 sessions they still are fighting the depression then they need to promise they will see a psychiatrist to see what is available medically for their condition.

Clinicians have described the consequences of having a depressive disorder in a variety of descriptors, but to enable an understanding of how Evidence Based Practices work in helping to overcome the deficits it is important to list them. They are: 1) Poor concentration – resulting in the inability to maintain focus over a long time resulting in automatic negative thoughts taking over since they do not require concentration. 2) Negative information processing-resulting in a cycle of negative thinking about one’s self, world and the future. 3) Poor attention-inability to direct or sustain focused attention which allows the automatic negative thought to take over. 4) Memory problems-making it difficult to remember healthy coping behaviors from one’s past and allowing only negative memories to come to the fore. 5) Poor problem solving-making it difficult for the client to set goals, set up a plan of action, and inability to draw on past successes in coping to build new ones. 6) Lack of motivation-making it difficult to get oneself to fight depressive thoughts or participate in strategies to overcome this inertia. 7) Lack of awareness of the physiological consequences of depression-which leads the client to become overly self-critical/self-loathing when making comparisons of the “old me who was not depressed” and the “new me who is so overly depressed.” (James, Reichelt, Carlsonn and McAnaney, 2008).


Clinicians assess and treat Depressive Disorders across all ages of clients. There include:

1) Children and adolescents (Ryan, 2005: Chrisman, Compton, Curry, Egger and Goldston, 2006: Nobile, Cataldo, Marino and Molteni, 2003; Sommers-Flannagan and Campbell, 2009).

2) College age and young adult (Lee, 2005) and middle aged adults.

3) Older adults (Driscoll et al., 2005:  Zalaquett and Stens, 2006; Hinrichsen, 2008; Blake, Mo, Malik and Thomas, 2009; Wiese, 2011).


Currently, there are a variety of Evidence Based Practices for treating Depressive Disorders. These include:

1) Pharmacotherapy only (Montgomery, 2006: Cipriani, Geddes, Furukawa and Barbui, 2007; Wiese, 2011; Spielmans, Berman, Linardatos, Rosenlicht, Perry and Tsai, 2013).

2) Cognitive Behavioral Therapy (CBT) only (Watson, Gordon, Stermac, Kalogerakos and Steckley, 2003): Butler, Chapman, Forman and Beck, 2004: James, Reichelt, Carlsonn and McAnaney, 2008; Lynch, Laws and McKenna, 2010; Cuijpers, Berking, Anderson, Quigley, Kleiboer and Dobson, 2013; Hundt, Mignogna, Underhill and Cully, 2013).

3) Combination of CBT with other therapies: a) Positive Psychology (Karwoski, Garratt and Iiardi, 2006). b) Mindfulness (Manicavasagar, Perich and Parker, 2012) c) Acceptance and commitment therapy (Gaudiano, Nowlan, Brown, Epstein-Lubow and Miller, 2013).

4) Interpersonal Psychotherapy (IPT) (Ellis, Hickie and Smith, 2003; Parker and Fletcher, 2007; Hinrichsen, 2008).

5) Process-Experiental Therapy (PET) (Watson, Gordon, Stermac, Kalogerakos and Steckley, 2003).

6) Combination of medication and individual therapy (Barrett et al., 2001; Nobile, Cataldo, Marino and Molteni, 2003; Lam and Kennedy, 2004; Mamber et al., 2008, Steidtmann, Manber, Arnow, Klein, Markowitz, Rothbaum, Thase and Kocsis, 2012).

6) Exercise with older adults (Blake, Mo, Malik and Thomas, 2009).

7) Family therapy or psychoeducation (Nobile, Cataldo, Marino and Molteni, 2003).

First Assignment for Walter and Greta after their first session


Please read and sign this tentative plan for overcoming your depression and to bring it back to next counseling session:

How can I overcome my depression?

In order to overcome depression I need to:

  1. Recognize that I am depressed and identify all of thoughts, emotions and behaviors which are contributing to this depression.
  2. Have a complete physical exam to rule out a physiological cause for my depression.
  3. Determine whether the depression is just situation specific (related to the death of my son) or chronic (a part of my behavior for a long period of time which I ignored or was unaware of).
  4. Identify other possible causes of my depression.
  5. Identify any irrational thinking contributing to my depression and develop a more realistic perspective.
  6. Accept that anger could be a basis for my depression, and make a concerted effort to do anger work-out sessions daily to get out whatever anger is still inside me so as to lessen its impact on me
  7. Realize that depression is a fact of life, that it accompanies loss, grief, and even success.
  8. Be open to find a place in my life for relaxation efforts such as mindfulness meditation, and progressive muscle relaxation.
  9. Use visual imagery to see my life without depression and put my energy into the pursuit of that positive goal.
  10. Develop a crisis prevention, time management, and catastrophic intervention plan of action to help snap me out of any relapsing into depression I might experience
  11. Develop a balanced lifestyle with good nutrition, a balanced diet, aerobic exercise, adequate sleep and stress reduction.
  12. Work at self-esteem enhancement, self-affirmation, self-reinforcement.

I will commit myself to a specific plan of action to overcome my depression in the next six months.

Signed                                                              Date

Adapted from: Chapter 3: Handling Depression in: Messina, J.J. (2013). Tools for Anger Workout, retrieved at www.coping.us

Pharmacotherapy with depressive disorders is the prescription of medications alone to treat the symptoms. The following chart lists the medications clinicians use in treating depressive disorders.


Medications Used for Depressive Disorders

Classification

Drug Name (Generic Name)

Tricyclic Antidepressants

Elavil (Amitriptyline) 

Sinequan (Doxepin)

Anafranil (Clomipramine)

Pamelor (Nortriptyline)

Tofranil (Imipramine)

Monoamine Oxidase Inhibitors: MAOI’s

Nardil (Phenelzine)

Parnate (Tranylcypromine)

Marplan (Isocarboxazid)

Selective Serotonin Reuptake Inhibitors: SSRI’s

Prozac (Fluoxetine)

Zoloft (Sertraline)

Paxil (Paroxetine)

Celexa (Citalopram)

Lexapro (Escitalopram)

Serotonin and Norepinephrine Reuptake Inhibitors: SNRI’s

Effexor (Venlafaxine HCl)

Cymbalta (Duloxetine HCI)

Pristiq (Desvenlafaxine)

Serotonin Antagonist Reuptake Inhibitor: SARI’s

Serzone (Nefazodone)

Dopamine Reuptake Inhibitor

Wellbutrin (Bupropion)

Atypical

Remeron (Mirtazapine)

Desyrel (Trazodone)


Cognitive Behavioral Therapy (CBT) is typically a short-term therapy of 16 or less sessions over six months. There are usually three phases in this treatment:


1) Initial phase with focus on behavioral change often called behavioral activation. Clients are taught to monitor daily living activities and experiences. They do this often by keeping a log of daily activities so they can identify patterns of avoidance or inactivity which feed their depression. With the logs, clients in therapy set behavioral goals to enhance their mood through changes of activities at work, in school or training, in scheduled health oriented exercises, during leisure time and in social relationships. The clients then watch for patterns of avoidance as they begin to work at achieving each of the long and short term goals. They make sure that they replace avoidance behaviors with healthy coping alternatives. As they achieve their goals, clinicians encourage clients to reward their achievements (Mor and Haran, 2009). Unfortunately, research has shown that clients who do not succeed in CBT in this first phase typically drop out due to the explicit homework assignments, even if they have experienced some good insights into their issues (Barnes et al., 2013).


2) Middle Phase which is focused on cognitive assessment and restructuring and use of journal writing to identify the self-defeating thoughts which come up when one faces events which one perceives as negative or experiencing feeling and automatic thoughts from such events. The clients then work at thought restructuring with the assistance of their CMHC and begin to recognize the self-defeating impact of their automatic negative thoughts or beliefs and how they negatively impact their feelings. Clients can change these negative beliefs and thoughts, also known as cognitive distortions, to help them function in the world in a much healther and saner way (Mor and Haran, 2009).


3) Final Phase is known as the relapse prevention phase in which clients work at altering their irrational, unhealthy and self-defeating beliefs and conduct behavioral experiments which help them test the validity of their new healthier, rational beliefs. Clinicians teach clients in this final phase to analyze their unhealthy coping mechanisms and improve their problem solving abilities. At the end of this phase they set goals for themselves which recognize that relapse is always possible and identify strategies to cope and deal with such relapse events when they arise (Mor and Haran, 2009).


Clinicians typically offer Interpersonal Psychotherapy (IPT) in 16 sessions. The covered topics can be from any or all of the following interpersonal problem areas: grief,  including complicated bereavement; interpersonal role conflicts with a significant other; role transitions due to life changes and aging; and interpersonal relationship deficits with problems in initiating and sustaining relationships (Hinrichsen, 2008).

Handouts for Walter and Greta to better explain the elements involved in their treatment

  1. TEA System
  2. ALERT System
  3. ANGER System
  4. LET GO System
  5. CHILD System
  6. RELAPSE System

All available online at: www. coping.us at: http://coping.us/seastoolsforrecovery.html

Treatment Workbooks for Depression


Addis, M.E. and Martell, C.R. (2004). Overcoming depression one step at a time: The new behavioral activation approach to getting your life back.Oakland, CA: New Harbinger Press.

 

Beck, J.S. (1995). Cognitive therapy: Basics and beyond. New York: The Guilford Press.

 

Beck, A.T., Rush, A.J., Shaw, B.F. and Emery, G. (1979). Cognitive therapy of depression. New York: The Guilford Press.

 

Beiling, P.J., Antony, M.M. and Beck, A.T. (2003). Ending the depression cycle: A step-by-step guide for preventing relapse. Oakland, CA: New Harbinger Press.

 

Burns, D.D. (1999). Feeling good: The new mood therapy. New York: HarperCollins.

 

Crane, R. (2009). Mindfulness-based cognitive therapy. New York: Routledge

 

Dahl, J.C., Plumb, J.C., Stewart, I. and Lundgren, T. (2009). The art and science of valuing in psychotherapy-helping clients discover, explore, and commit to valued action using acceptance and commitment Tterapy. Oakland, CA: New Harbinger Publications, Inc.

 

D'Zurilla, T.J. and Nezu, A. M. (2007). Problem solving therapy: A positive approach to clinical interventions, third edition. New York: Springer Publishing Co.

 

Gilson, M. and Freemen, A. (2000). Overcoming depression: A cognitive therapy approach for taming the depression beast: Client workbook. New York: Oxford University Press.

 

Gilson, M., Freeman, A., Yates, M.J. and Freeman, S.M. (2009). Overcoming depression: A cognitive therapy approach-second edition: Client workbook. New York: Oxford University Press.

 

Gilson, M., Freeman, A., Yates, M.J. and Freeman, S.M. (2009). Overcoming depression: A cognitive therapy approach-second edition: Therapist guide. New York: Oxford University Press.

 

Hayes, S.C., Strosahl, K.D. and Wilson, K.G. (2003). Acceptance and commitment therapy: An experiential approach to behavior change. Oakland, CA: New Harbinger Press

 

Hayes, S.C., Follette, V.M. and Linehan, M.M. (2004). Expanding the cognitive-behavioral tradition – Mindfulness and acceptance. New York: The Guilford Press.

 

Hayes, S.C. and Smith, S. (2005). Get out of your mind and into your Life:The new acceptance and commitment therapy. Oakland, CA: New Harbinger Press.

 

Kanter, J.W., Busch, A.M. and Rusch, L.C. (2009). Behavioral activation. New York: Routledge.

 

Martell, C.R., Addis, M.E. and Jacobson, N.S. (2001). Depression in context: Strategies for guided Aation. New York: Norton.

 

Martell, C.R., Dimidjian, S. and Herman-Dunn, R. (2010). Behavioral activation for depression: A clinician’s guide. New York: The Guilford Press.

 

McCown, D., Reibel, D. and Micozzi, M.S. (2010). Teaching mindfulness: A practical guide for clinicians and educators. New York: Springer.

 

McCullough, J.P. (2000). Treatment for chronic depression: Cognitive behavioral analysis system of psychotherapy (CBASP). New York: The Guilford Press.

 

McCullough, J.P. (2001). Skills training manual for diagnosing and treating chronic depression: Cognitive behavioral analysis system of psychotherapy.New York: The Guilford Press.

 

McCullough, J.P. (2003). Patient’s manual for CBASP. New York: The Guilford Press.

 

McCullough, J.P. (2006). Treating chronic depression with disciplined personal involvement: CBASP. New York: Springer-Verlag.

 

McKay, M., Forsyth, J.P. and Eifert, G.H. (2010). Your life on purpose-How to find what matters and create the life you want. Oakland, CA: New Harbinger Publications.

 

Messina, J.J. (2013). Tools for coping series: (1) Self-esteem seekers anonymous-The SEA’s program manual; (2) Laying the foundation: Personality traits of low self-esteem; (3) Tools for handling loss; (4) Tools for personal growth; (5) Tools for relationships; (6) Tools for communications; (7) Tools for anger work-out; (8) Tools for handling control issue; (9) Growing down:Tools for healing the inner child; (11) Tools for a balanced lifestyle, retrieved at www.coping.us

 

Nezu, A.M., Nezu, C.M. and D’Zurilla, T.J. (2007). Solving life’s problems: A 5-step guide to enhanced well-being. New York: Springer Publishing, Co.

 

Papageorgiou, C. and Wells, A. (2004). Depressive rumination-nature, theory and treatment. Hoboken, NJ: John Wiley & Sons Inc.

 

Pettit, J.W., Joiner, T.E. and Rehm, L.P. (2005). The interpersonal solution to depression: A workbook for changing how you feel by hanging how you relate. Oakland, CA: New Harbinger Publications Inc.

 

Roemer, L. and Orsillo, S.M. (2009). Mindfulness-and-acceptance-based behavioral therapies in practice. New York: The Guildford Press.

 

Rohan, K.J. (2009). Coping with the seasons: A cognitive-behavioral approach to seasonal affective disorder: Therapist Guide. New York: Oxford University Press.

 

Segal, Z.V., Williams, J.M.G. and Teasdale, J.D. (2001). Mindfulness-based cognitive therapy for depression: A new approach in preventing relapse. New York: The Guilford Press

.

Strauss, C. (2004). Talking to depression. New York: New American Library.

 

Siegel, R.D. (2010). The mindfulness solution: Everyday practices for everyday problems. New York: The Guildford Press.

 

Weissman, M.M. (2005). Mastering depression through interpersonal psychotherapy: Patient workbook. New York: Oxford University Press.

 

Weissman, M.M., Markowtiz, J.C. and Klerman, G.L. (2000). Comprehensive guide to interpersonal psychotherapy. New York: Basic Books. New York: Oxford University Press.

 

Wells, A. (2009). Metacognitive therapy for anxiety and depression. New York: The Guilford Press.

 

Wilfy, D.E., Mackenzie, K.R., Welch, R.R., Ayers, V.E. and Weissman, M.M.

(2000). Interpersonal psychotherapy for group. New York: Basic Books.

 

Williams, J., Teasdale, J., Segal, Z. and Kabat-Zinn, J. (2007). The mindful way through depression: Freeing yourself from chronic unhappiness. New York: Guilford.

References for Depressive Disorders


Barnes, M., Sherlock, S., Thomas, L., Kessler, D. Kuyken, W., Owen-Smith, A., Lewis, G.,

Wiles, N. and Turner, K. (2013). No pain, no gain: Depressed clients’ experiences of cognitive behavioral therapy. British Journal of Clinical Psychology, 52.347-364. DOI:10.1111/bjc.12021

 

Barrett, J., Williams Jr., J.W., Oxman, T. E., Frank, E., Katon, W., Sullivan, M., Hegel, M.,

Cornell, J.E. and Sengupta, A.S. (2001). Treatment of dysthymia and minor depression in medical care. Journal of Family Care, 50(5), 405-412. 

 

Blake, H., Mo, P., Malik, S. and Thomas, S. (2009). How effective are physical activity

interventions for alleviating depressive symptoms in older people? A systematic review.Clinical Rehabilitation,23, 873-887. doi: 10.1177/0269215509337449 

 

Butler, A.C., Chapman, J.E., Forman, E.M. and Beck, A.T. (2004). The empirical status of

cognitive-behavioral therapy: A review of meta-analyses. Clinical Psychology Review, 26, 17-31. doi:10.1016/j.cpr.2005.07.003 

 

Chrisman A., Compton, S., Curry, J., Egger H. and Goldston, D. (2006). Assessment of

childhood depression. Child and Adolescent Mental Health, 11(2), 111-116. doi: 10.1111/j.1475-3588.2006.00395.x 

 

Cipriani, A., Geddes, J., Furukawa, T., and Barbui, C. (2007). Meta-review on short-term

effectiveness and safety of antidepressants for depression: An evidence-based approach to inform clinical practice. The Canadian Journal of Psychiatry / La Revue canadienne de psychiatrie, 52(9), 553-562. 

 

Cuijpers, P, Berking, M., Anderson, G., Quigley, L., Kleiboer, A. and Dobson, K.S. (2013). A

Meta-analysis of cognitive-behavioural therapy for adult depression, alone and in comparison with other treatments. Canadian Journal of Psychiatry, 58(7), 376-385.

 

Driscoll, H., Basinki, J., Mulsant, B., Butters, M. A., Dew, M. A., Houck, P. R., Mazumdar, S.,

Miller, M. D., Pollock, B. G., Stack, J. A., Schlernaitzauer, M. A. and Reynolds, C. F. (2005). Late-onset major depression: Clinical and treatment-response variability. International Journal of Geriatric Psychiatry, 20, 661-667. doi: 10.1002/gps.1334 

 

Ellis, P.M., Hickie, I.B., and Smith D.A.R. (2003). Summary of guideline for the treatment of

depression. Australasian Psychiatry. 11(1), 34-38. 

 

Gaudiano, B.A., Nowlan, K., Brown, L.A. Epstein-Lubow, G. and Miller, I.W. (2013). An open

trial of a new acceptance-based behavioral treatment for major depression with psychotic features. Behavior Modification, 37(3), 324-355.  DOI: 10.1177/0145445512465173

 

Hinrichsen, G.A. (2008). Interpersonal psychotherapy as a treatment for depression in later

life. Professional Psychology: Research and Practice, 39(3), 306-312. doi: 10.1037/0735-7028.39.3.306 

 

Hundt, N.E., Mignogna, J., Underhill, C. and Cully, J.A. (2013). The relationship between use of

CBT skills and depression treatment: A theoretical and methodological review of the literature. Behviour Therapy, 44(1), 12-26. DOI: 10.1016/j.beth.2012.10.001

 

James, I., Reichelt, K., Carlsonn, P., and McAnaney, A. (2008). Cognitive behavior therapy and

executive functioning in depression. Journal of Cognitive Psychotherapy: An International Quarterly, 22(3), 210-220. doi: 10.1891/0889-8391.22.3.210

 

Karwoski, L., Garratt, G. M. and Iiardi, S. S. (2006). On the integration of cognitive-behavioral

therapy for depression and positive psychology. Journal of Cognitive Psychotherapy, 20(2), 159-170. 

 

Lam, R. W. and Kennedy, S. H. (2004). Evidence based strategies for achieving and sustaining

full remission in depression: Focus on metaanalysis. Canadian Journal of Psychiatry, 49(Suppl 1), 17S-26S. 

 

Lee, C. (2005). Evidenced-based treatment of depression in the college population.Journal of

College Student Psychotherapy, 20(1), 23-31. doi:10.1300/J035v20n01_03 

 

Lynch, D., Laws, K.R. and McKenna, P.J. (2010). Cognitive behavioural therapy for major

psychiatric disorder: does it really work? A meta-analytical review of well-controlled trials. Psychological Medicine, 40, 9-24. DOI:10.1017/S003329170900590X

 

Mamber, R., Kraemer, H.C., Arnow, B.A., Ttrivedi, M.H., Rush, J.A., Thase, M.E., Rothbaum,

B.O., Klein, D.N., Kocsis, J.H., Gelenberg, A.J. and Keller, M.E. (2008). Faster remission of chronic depression with combined psychotherapy and medication than with each therapy alone. Journal of Counseling and Clinical Psychology, 76(3), 459-467. doi: 10.1037/0022-006X.76.3.459 

 

Manicavasagar, V., Perich, T. and Parker, G. (2012). Cognitive predictors of change in cognitive

behaviour therapy and mindfulness-based cognitive therapy for depression. (2012). Behavioral and Cognitive Psychotherapy, 40(2), 227-232. DOI: 10.1017/S1352465811000634

 

Montgomery, S. A. (2006). Guidelines in major depressive disorder, and their

limitations. International Journal of Psychiatry in Clinical Practice, 3(10), 3-9. doi: 10.1080/13651500600940492 

 

Mor, N. and Haran, D. (2009). Cognitive-behavioral therapy for depression. The Israel Journal

of Psychiatry and Related Sciences, 46(4), 269-273. 

 

Nobile, M., Cataldo, G., Marino, C. and Molteni, M. (2003). Diagnosis and treatment of

dysthymia in children and adolescents. CNS Drugs, 17(13), 927-947. 

 

Parker, G. and Fletcher, K. (2007). Treating depression with the evidence-based psychotherapies:

A critique of the evidence. Acta Psychiatrica Scandinavica, 115(1), 352-359. doi: 10.1111/j.1600-0447.2007.01007.x 

 

Ryan, N. (2005). Treatment of depression in children and adolescents. Lancet, 366(9489), 933-

940. 

 

Sommers-Flannagan, J. and Campbell, D. C. (2009). Psychotherapy and (or) medications for

depression in youth? An evidence-based review with recommendations for treatment. Journal of Contemporary Psychotherapy, 39, 111120. doi:10.1007/s10879-008-9106-0 

 

Spielmans, G.I., Berman, M.I., Linardatos, E., Rosenlicht, N.Z. Perry, A. and Tsai, A.C. (2013).

Adjunctive atypical antipsychotic treatment for major depressive disorder: A meta-analysis of depression, quality of life, and safety outcomes. PLoS Med 10(3), e1001403. doi:10.1371/journal.pmed.1001403

 

Steidtmann, D., Manber, R., Arnow, B.A., Klein, D.N., Markowitz, J.C., Rothbaum, B.O.,

Thase, M.E. and Kocsis, J.H. (2012). Patient treatment preference as a predictor of response and attrition in treatement for chronic depression. Depression and Anxiety, 29, 896-905. DOI 10.1002/da.21977

 

Watson, J. C., Gordon, L. B., Stermac, L., Kalogerakos, F. and Steckley, P. (2003). Comparing

the effectiveness of process-experiential with cognitive-behavioral psychotherapy in the treatment of depression. Journal of Consulting and Clinical Psychology, 71(4), 773-781. doi: 10.1037/0022-006X.71.4.7 

 

Wiese, B.S. (2011). Geriatric depression: The use of antidepressants in the elderly. British

Columbia Medical Journal, 53(7), 341-347

 

 Zalaquett, C. P. and Stens, A.N. (2006). Psychosocial treatments for major depression and

dysthymia in older adults: A review of the research literature.  Journal of Counseling and Development, 84(2), 192-201.  

WHERE DO I GO FROM HERE?

CONCERNING DEPRESSIVE DISORDERS

Now that you have read this section, in “My Mental Health Professional Practitioner Journal” record your answers and reactions to the following questions:

  1. How will this information help me as a Mental Health Professional?
  2. How interested am I in implementing Evidence Based Practices concerning Depressive Disorders in my clinical practice?
  3. Why is it important that I learn more about Depressive Disorders?
  4. What more do I need to know about Depressive Disorders?
  5. Where can I go to obtain more information about Depressive Disorders?
  6. Where can I go to obtain the journal articles, manuals, workbooks or guidebooks on Depressive Disorders?