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Drugs and Psychotherapy in Acute Depression

Jeffrey Mattes, MD
Arch Gen Psychiatry. 1981;38(1):115. doi:10.1001/archpsyc.1981.01780260117016.
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To the Editor.—  I found the article by DiMascio et al entitled "Differential Symptom Reduction by Drugs and Psychotherapy in Acute Depression" (Archives 36:1450-1456, 1979) some-what disconcerting, partly because the conclusion seemed contrary to my impression of good clinical practice. Specifically, the recommendation to combine medication and psychotherapy was surprising to me in that, clinically, there are numerous patients who do very well with medication alone and have no need for psychotherapy and, on the other hand, there are many patients who are not helped at all by medication while they may be helped by psychotherapy. Certainly there are a number of patients who can benefit by combined treatment, but to recommend this combination on a routine basis seems clinically unnecessary. It is quite common for research regarding psychotherapy to be relatively irrelevant to and to have no effect on clinical practice, but this state of affairs is certainly unfortunate


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