Abstract
BackgroundChronic depressions represent a substantial part of depressive disorders and are associated with severe consequences. Several studies were performed addressing the effectiveness of psychotherapeutic, pharmacological, and combined treatments for chronic depressions. Yet, a systematic review comparing the effectiveness of multiple treatment options and considering all subtypes of chronic depressions is still missing.Methods/DesignAim of this project is to summarize empirical evidence on efficacy and effectiveness of treatments for chronic depression by means of a systematic review. The primary objectives of the study are to examine, which interventions are effective; to examine, if any differences in effectiveness between active treatment options exist; and to find possible treatment effect modifiers. Psychotherapeutic, pharmacological, and combined treatments will be considered as experimental interventions and no treatment, wait-list, psychological/pharmacological placebo, treatment as usual, and other active treatments will be seen as comparators. The population of patients will include adults with chronic major depression, dysthymia, double depression, or recurrent depression without complete remission between episodes. Outcomes of the analyses are depressive symptoms, associated consequences, adverse events, and study discontinuation. Only randomized controlled trials will be considered.DiscussionGiven the high prevalence and serious consequences of chronic depression and a considerable amount of existing primary studies addressing the effectiveness of different treatments the present systematic review may be of high relevance. Special attention will be given to the use of current methodological standards. Findings are likely to provide crucial information that may help clinicians to choose the appropriate treatment for chronically depressed patients.
Highlights
Chronic depressions represent a substantial part of depressive disorders and are associated with severe consequences
Given the high prevalence and serious consequences of chronic depression and a considerable amount of existing primary studies addressing the effectiveness of different treatments the present systematic review may be of high relevance
Special attention will be given to the use of current methodological standards
Summary
Chronic depressions represent a substantial part of depressive disorders and are associated with severe consequences. Several studies were performed addressing the effectiveness of psychotherapeutic, pharmacological, and combined treatments for chronic depressions. A systematic review comparing the effectiveness of multiple treatment options and considering all subtypes of chronic depressions is still missing. Chronic depressions represent a substantial part of depressive disorders. Dysthymic disorder is defined as a mild condition that is chronic and persistent for at least 2 years. Chronic type, refers to a more severe condition that meets full criteria for major depression continuously for a minimum of 2 years. There is evidence from diverse studies that about 20% of all patients diagnosed with major depression develop a chronic course [2,3]. Among psychiatric outpatients up to 36% suffer from dysthymia [7]
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