Group therapy in combination with medication treatment improves stress hormone levels for depressed patients, according to a recently published study by a group of Taiwanese researchers.
While psychotherapy has often been demonstrated to improve subjective outcomes, scientists sought to assess whether such treatment, combined with drug therapy, produces long-term biological improvements.
Published in the journal Psychotherapy and Psychosomatics, scientists evaluated the cortisol levels of depressed patients who were undergoing psychotherapy treatment while simultaneously taking medication for their conditions. Study participants were diagnosed with major depressive disorder and recruited from a hospital outpatient psychiatric department.
Clinical depression is a mood disorder characterized by ongoing, persistent feelings of sadness, hopelessness, or worthlessness that interfere with daily life. Depressed people tend to perceive themselves and their lives negatively, experiencing symptoms such as changes in appetite and sleep patterns, fatigue, difficulty concentrating, irritability, self-loathing and withdrawal from enjoyable activities. Studies have linked anxiety and depression, with similar triggers, symptoms and biological changes reported in both disorders.
Single Therapy Vs. Combination Therapy
In this study, 63 participants were randomly assigned into two cohorts: 29 received group psychotherapy and medication, while 34 received only medication. The first group engaged in 8 weekly group therapy sessions focusing on mind-body connections. They were assessed via the Beck Depression Inventory II and State Trait Anxiety Inventory tests collected at their homes.
Cortisol levels were measured, with saliva samples taken upon awakening, 45 minutes after arising, and at 3 additional intervals throughout the day. Follow up tests were also conducted upon conclusion of psychotherapy and at five and eight months thereafter.
Cortisol is a hormone that naturally fluctuates throughout the day but is released in greater amounts in response to stress. The surge helps the body mount a response to stressful situations and is not harmful under normal circumstances. Prolonged elevated cortisol levels triggered by chronic stress, however, may cause various negative biological consequences.
The Benefits of Dual Therapy
Results of this research revealed a greater reduction in anxiety for the patients who received the combination therapy and medication treatments at their eight-month follow up assessments. Researchers reported that this group was more likely to have steeper daytime cortisol patterns than those treated with medication alone during all three follow-up periods. Decreases in depression symptoms were similar in both groups.
Researchers suggested that as an added treatment, psychotherapy could potentially produce positive long-term biological changes on stress hormone levels, resulting in reduced anxiety.
Psychotherapy is a form of counseling provided by trained and licensed specialists to treat mental illnesses. Private and group therapies encompass various techniques to help patients identify underlying causes or triggers of emotions and behaviors. Patients are guided by therapists to talk about their problems and learn coping skills to help manage and overcome challenges.
In group settings, therapy enables participants to share experiences, develop a support network and learn from others experiencing similar issues. Psychotherapy is used to treat numerous psychiatric diagnoses and is often administered in conjunction with drug therapy. There are a wide variety of psychotherapeutic approaches and duration of treatment can vary greatly depending on the type of psychotherapy and the patient's diagnosis.
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Date of original publication: April 10, 2013