The reviewed paper is by Barbato and D’Avanzo and looks at Couples Therapy for Depression. NICE have prepared guidelines for depression and comment on Couples therapy. Couple focused therapy is recommended in the NICE guidelines in moderate to severe depression that hasn’t responded to treatment. The current meta-analysis is therefore important. In the introduction the authors describe the theoretical background, identifying partner criticism as an aetiological factor in depression. They also identify protective factors including intimacy and helping to develop coping strategies.
The authors included studies with depression outcome scales, age 16-65, and couples therapy intervention with or without comparators. The selection process was very impressive including the Cochrane Database Register, a handsearch of 52 psychiatry and psychology journals between 1995 and 2006 as well as other selected journals.
The authors included 8 studies in their meta-analysis the majority of which lasted 16 weeks and included people with mild-to-moderate depression. Many of the studies used the Dyadic Assessment Schedule (DAS) for the assessment of relationships and also continuous depression outcome measures. The essential finding from this meta-analysis was that there was no significant reduction in depression scores resulting from couples therapy although there was a reduction in relationship distress. The authors conclude with a number of recommendations including further studies with a longer follow-up period.
In summary, the authors of this meta-analysis find that couples therapy is effective at improving relationship distress but not depressive symptoms in couples where one partner has depression. This study might be included in the next NICE update on depression. An interesting conclusion that could be drawn is that despite one partner having depression couples therapy can improve relationship distress.
Angelo Barbato and Barbara D’Avanzo. Efficacy of Couple Therapy as a Treatment for Depression: A Meta-Analysis. Psychiatry Quarterly. 2008. 79. 121-132.
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