RESUMO
This article presents the results of a large efficacy study comparing different forms of therapy for major depressive disorder (MDD), including interpersonal psychotherapy (IPT) and pharmacotherapy. Patients were randomized to either IPT, IPT in combination with anti-depressant medication, IPT in combination with pill-placebo or medication only. The primary outcome measure was the Hamilton Rating Scale for Depression (HAMD). Patients were treated for 12 to 16 weeks. Ratings were performed at baseline, after 6 weeks of treatment and at the end of treatment. Ethnic minority patients (EMP) had higher scores on the HAMD than non-EMP for every rating period. However, the rate of improvement was the same for EMP and non-EMP. The higher mean scores of EMP on the HAMD could not be explained as solely due to higher scores on somatic items of the rating scales. The attrition rate in EMP (45.9%) was significantly higher than in non-EMP (24.4%), even in the structured treatment format studied. The results suggest that standard antidepressant therapy, be it medication, psychotherapy or both, may be effective for depressed minority patients but therapists should focus on enhancing adherence to treatment.
Assuntos
Antidepressivos de Segunda Geração/uso terapêutico , Comparação Transcultural , Transtorno Depressivo Maior/etnologia , Transtorno Depressivo Maior/terapia , Psicoterapia , Triazóis/uso terapêutico , Adulto , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Marrocos/etnologia , Países Baixos , Piperazinas , Suriname/etnologia , Turquia/etnologiaRESUMO
Former political prisoners in Chile gave testimony of their traumatic experiences, which resulted in diminishing their posttraumatic symptoms. Based on this experience, testimony therapy has been developed and used in treatment of traumatized victims of war or other organized violence. This short-term therapy, as it applied in the treatment of traumatized asylum seekers and refugees in Centrum '45/De Vonk in the Netherlands, is described in this article. The therapy consists of 12 sessions in which patients tell their life stories, including the traumatic experiences. The narrative is reflected in a written document that, for example, can be read to family and friends, or be sent to a historical archive. This article discusses the preliminary research data on the effects of testimony therapy. Finally, hypotheses on the working mechanisms of testimony therapy are offered.