An international team of researchers, including specialists from the Medical University of Vienna, presented a finding at the European Psychiatric Congress held in Budapest. The study explored how psychotherapy interacts with pharmacological treatment for severe depression, specifically focusing on whether adding psychotherapy to a regimen that already includes antidepressants yields meaningful improvements in outcomes for patients facing significant depressive symptoms.
The research analyzed treatment results from a sizable cohort of 1,279 adults diagnosed with severe depression. All participants were receiving antidepressant medication, and a subset—roughly one third—also received structured psychotherapy over the course of their treatment. The patient group tended to be younger, more educated, and to use relatively lower antidepressant doses compared with other patients in the study. When scientists compared those who received antidepressants alone to those who received both antidepressants and psychotherapy, they did not observe a statistically significant difference in the primary measures of depressive symptoms and functional recovery. These findings suggest that, within this specific clinical context, adding psychotherapy to an ongoing antidepressant treatment did not demonstrate a clear advantage in reducing core depressive symptoms over the study period.
A pair of key takeaways emerged from the analysis. First, for patients already treated with antidepressants, the addition of psychotherapy did not appear to strengthen the objective outcomes of depression treatment, even though some individuals reported an improvement in subjective well-being or mood. Second, patients with severe depression who also received psychotherapy tended to present more favorable socio-demographic profiles and clinical characteristics at the outset, compared with those who did not undergo additional psychotherapy. This observation highlights how baseline factors may influence both access to psychotherapy and the perceived benefits that patients experience during treatment.
Despite these findings, the researchers emphasized that the results should not be interpreted as psychotherapy being ineffective for all cases of severe depression. Rather, they call for a nuanced reexamination of treatment strategies for this condition. The study suggests that clinicians may need to tailor approaches more precisely to individual patient profiles, considering a broader array of outcomes beyond symptom scores alone. In clinical practice, this could mean balancing the potential benefits of psychotherapy for subjective well-being against the measured improvements in depressive symptoms and adjusting treatment plans accordingly. The overall message is an invitation to rethink care pathways for severe depression, ensuring that decisions around psychotherapy and medication are informed by comprehensive, patient-centered evidence rather than a one-size-fits-all framework.