Combining psychotherapy, delivered over the telephone, with medication seems to improve the outcome of depression treatment, research shows.

In the United States, people who suffer depression are typically treated with an antidepressant, often prescribed by a primary care doctor, without formal psychotherapy.

Yet a type of psychotherapy called “cognitive-behavior” therapy or CBT has been shown to help curb depression. CBT involves learning to recognize and address distorted thoughts and feelings that lead to emotional distress. CBT is usually performed in an office setting.

In their study, Dr. Evette J. Ludman and colleagues from Group Health Cooperative, Seattle, Washington, randomly assigned 393 depressed patients initiating antidepressant medication to usual care alone or with telephone-based CBT, consisting of 8 sessions during the first 6 months and 2 to 4 “booster” sessions in the second 6 months.

All patients were contacted for outcome assessments at 6 weeks and at various time points up to 18 months after the start of the study.

Improvement depression was greater in patients in the phone therapy group than in those assigned to usual care, Ludman and colleagues found.

At 18 months, 77 percent of patients in the phone therapy group reported their depression was “much improved” or “very much improved,” compared to 63 percent of those in the usual-care group, a significant difference favoring phone-based CBT.

Subjects in the phone therapy group were also slightly better at taking their antidepressant medication as recommended.

This study, the authors conclude, suggest that the “addition of a brief, structured CBT programs can significantly improve clinical outcomes for the large number of patients beginning antidepressant treatment in primary care.”

SOURCE: Journal of Consulting and Clinical Psychology, April 2007.