There has been a lot of recent discussion about recovery from depression, sparked by the results of the largest ever treatment trial (STAR*D) and its indicator that more and new combinations of antidepressant drugs for an increased level of remission were essential.

Some Italian investigators interpert the same data in a different way: the more you use antidepressant drugs, the worse is the long-term outcome, they say.

Giovanni A. Fava and associates (University of Bologna) have published this new analysis in the September issue of Psychotherapy and Psychosomatics.

The paper analyzes some issues which may hinder effective treatment of major depressive disorders: the inadequacies of a cross-sectional DSM assessment without clinical differentiation of the extent, development and seriousness of the disturbances (staging); over-emphasis on and prolongation of drug treatment, without paying attention to problems related to tolerance; neglect of the active role of the patient in achieving recovery, with the integration of psychotherapeutic strategies in a sequential model.

If we are able to remove the conceptual obstacles which obstruct our view of depression and silence the sound of propaganda, we may then become aware of a different scenario in mood disorders and be able to develop therapeutic strategies of enduring quality.

Article: Fava, G.A. ; Tomba, E. ; Grandi, S.The Road to Recovery from Depression - Don't Drive Today with Yesterday's Map. Psychother Psychosom 2007;76:260-265