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DEPRESSION AND FAMILY RELATIONSHIPS

DEPRESSION AND FAMILY RELATIONSHIPS. RELATIVES’ CRITICAL COMMENTS AND RELAPSE OF DEPRESSION. CRITICAL % RELAPSE P STUDY COMMENTS VAUGHN & 2+ 67 LEFF (1976) 0-1 22 0.032 HOOLEY (1985) 2+ 59 0-1 0 0.014

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DEPRESSION AND FAMILY RELATIONSHIPS

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  1. DEPRESSION AND FAMILY RELATIONSHIPS

  2. RELATIVES’ CRITICAL COMMENTS AND RELAPSE OF DEPRESSION CRITICAL % RELAPSE P STUDY COMMENTS VAUGHN & 2+ 67 LEFF (1976) 0-1 220.032 HOOLEY (1985) 2+ 59 0-1 00.014 OKASHA et al (1994) 3+ 73 0-2 200.008

  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 12-20 SESSIONS 40 PATIENTS

  5. THE LONDON DEPRESSION INTERVENTION TRIAL • ANTIDEPRESSANT (DESIPRAMINE OR FLUOXETINE) 37 PATIENTS • COUPLE THERAPY 12-20 SESSIONS 40 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

  8. 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

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

  10. UK GOVERNMENT ANOUNCES BIGGEST RISE IN ANTIDEPRESSANT PRESCRIPTIONS EVER • 2008 35.9 MILLION • 2009 39.1 MILLION

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