Treatments of depression

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Introduction and ECT

  • Depression is the most common mental disorder with 1 in 6 people having it at come point in their lives. Various treatments for it.
  • ECT involves an ellectrical current being passed through the pateints head which induces a chock. Bilateral=both frontal lobes. Unilateral=one frontal lobe. The seizure lasts for a few minutes and is used as a punichment to 'reset' the brain.
  • Sackheim (1989) reviewed controlled comparisons of real ECT and placebo ECT. Real ECT was slightly more effective than stimulated. Bilateral more effective than unilateral but produced more memory deficits. Suggests ECT is effective as a treatment and shows that there is some basis in real ECT that affects the brian. However, study disproves ECT as a punishment as it it were real ECT and pplacebo ECT would have the same results.
  • Buchan et al (1992) compared reals ECT with stimulated ECT. Real ECT only had an affect with pateints whose depression was accompanied by physical delusions (very small minorty). At 6 months there wer eno difference between the placebo and treatment gorups. Contridicts first study as concluded that ECT not effective as a treatment of depression.
  • ECT onyl used for severe depression. Johnstone (2003) reported that in 1999, 11000 pateints were given ECT and 2/3 were women and it alleviated symptoms in 50% of cases. Suggests more women participants are used in studies of depression - gender bias. However, known that women are more likely to be diagnosed with the illness as men self-medicate.
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  • CBT a therapy which aims to change maladpative thoughts. Thought that when people think depressive thoughts, their life becomes depressive. Aims to change these so pateints have positive outlook on life.
  • Dobson (1989) meta-analysis of therapies for depression which showed that Becks triad acheived greater short term improvement than numberous other theapies, such as drugs and behavioural treatments. Reliable as made conclusion form more than one study. However, only states short term effects, indicating it was not effecitve in the long term.
  • Holmes (2002) found that CBT was less effective than anti-depressant drugs. 
  • However, Kuyken and Tsivikos (2009) found that 15% of variance in outcome may be attributable to how effectively therapists conduct CBT.
  • Conclusion - Both ECT and CBT effective and ineffective. Depends on the pateint as all people are individuals and respond to treatments differently.
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