Dynamics of fever and the cytokine network in systemic juvenile arthritis

BACKGROUND: Until the middle of the 20th century available treatment for depressive disorders was largely supportive and palliative. In the following decades, monoamine oxidase inhibitors and tricyclic antidepressants have been introduced. Unfortunately, the limitations of these drugs have been increasingly recognized. Thus, agents must be chosen based on their side effect profile, acceptability for long-term prophylaxis and any clinical lore regarding possible syndromal selectivity of response. The role of combination therapies is well recognized in many cases of major depressive disorders. The author's goal of study was to assess the effectiveness of psychotherapies on hospitalized depressive patients. METHODS: Sixty-two patients with major depressive disorders (MDD) were treated for eight sessions of behavioral, cognitive, or supportive group psychotherapy. During the treatment period, 16 of these subjects were assigned to a 4-week non-psychotherapeutic treatment control condition. All the above depressive patients received tricyclic antidepressants including Amitriptyline, lmipramine or Doxepine. RESULTS: By the end of four weeks patients in the three psychotherapeutic treatment groups showed significant improvement as compared with the controls. Overall, 58% of the psychotherapeutic treatment samples attained remission by termination; another 21% showed significant improvement. The remainder still met the criteria for MDD at the conclusion of therapy. A number of outcome measures indicated no significant difference for any of the three modalities in obtaining positive results. CONCLUSIONS: The therapeutic effect of depressed inpatients responding to these psychotherapies compares favorably with the controls, indicating the efficacy of psychotherapy for treatment of depressive inpatients.