8 misconceptions about depression and its treatment

As a result of a publication in El Mundo (digital version) in 2015 in which various misconceptions about depressive disorder. Sanz and García-Vera (2017), from the Complutense University of Madrid, have carried out an exhaustive review on this subject in order to shed some shed light on the veracity of the information contained in this text (and many others that can be found today on countless web pages or blogs of psychology). And it is that on many occasions such data seems not to be based on proven scientific knowledge.

The following is a list of the conclusions supposedly accepted and published by the Writing of the DMedicina portal (2015), the same group of specialists that carries out the edition in El World. These ideas refer both to the nature of depressive psychopathology as well as to the efficacy indices of psychological interventions that are applied for its treatment.

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Misconceptions about Depressive Disorder

When it comes to misconceptions about depression itself, we found the following.

1. When everything in life is going well for you, you can get depressed

Contrary to what was published in the article in El Mundo, according to the scientific literature this statement should be considered partially false, since the findings indicate that the relationship between previous life stressors and depression is stronger than expected. In addition, depression is given a disease connotation, which entails attributing more biological than environmental causation to it. Regarding the latter, science affirms that there is a small number of cases of depression without a previous history of external stressors.

2. Depression is not a chronic illness that never goes away.

From the article in El Mundo it is considered that depression is a condition that never completely goes away, despite the fact that the arguments that support it are not completely true.

First, the wording in question states that the rate of effectiveness of the intervention pharmacological is 90%, when in many meta-analysis studies carried out in the last decade (Magni et al. 2013; Leutch, Huhn, and Leutch 2012; Omari et al. 2010; Cipriani, Santilli et al 2009) an approximate percentage of the 50-60% efficacy to psychiatric treatment, depending on the drug used: SSRIs either tricyclic antidepressants.

On the other hand, the authors of the review article add that in the conclusions of a recent meta-analysis (Johnsen & Friborg, 2015) on 43 In the analyzed studies, 57% of patients were in total remission after a cognitive-behavioral intervention, so it can be settle a similar efficacy rate between pharmacological and psychotherapeutic prescription empirically validated.

3. There are no people who fake depression to get sick leave

The editorial staff of the portal affirms that it is very difficult to deceive the professional by simulating depression, so there are practically no cases of feigned depression. However, Sanz and García-Vera (2017) present the data obtained in various investigations in which the percentages of malingering depression can range from 8 to 30%, this last result in cases where labor compensation is linked.

Thus, despite the fact that it can be considered that a greater proportion of the population that is visited in primary care is not simulating said psychopathology, the affirmation that there are no cases in which this does not happen cannot be considered valid. casuistry.

4. Optimistic and extroverted people get depressed as much or more than those who are not.

The article we are talking about defends the idea that due to the greater affective intensity of the optimistic and extroverted people, these are the most likely to suffer a depression. On the contrary, the list of studies presented by Sanz and García-Vera (2017) in their text affirm precisely the opposite. These authors cite the meta-analysis by Kotov, Gamez, Schmidt and Watson (2010) where it was found lower indices of extraversion in patients with unipolar depression and dysthymia.

On the other hand, it has been indicated that optimism becomes a protective factor against depression, such and as corroborated by studies such as those by Giltay, Zitman and Kromhout (2006) or Vickers and Vogeltanz (2000).

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Misconceptions about the treatment of Depressive Disorder

These are other of the errors that can be made when thinking about the psychotherapeutic treatments applied to depressive disorders.

1. Psychotherapy does not cure depression

According to the article in El Mundo, there is no study that shows that psychological intervention allows depression to subside, although it does assume that it can be effective in the presence of some milder depressive symptoms, such as those that occur in adaptive. Thus, he defends that the only effective treatment is pharmacological.

The data obtained in the Cuijpers, Berking et al (2013) matanalysis indicate the opposite of this conclusion, since they found that the Cognitive Behavioral Therapy (TCC) was significantly superior to waiting list or treatment as usual (consisting of various psychopharmaceuticals, psychoeducation sessions, etc.).

In addition, the data previously provided on the study by Johnsen and Friborg (2015) corroborates the falsity of this initial statement. In the text, the effectiveness proven in studies on Behavioral Activation Therapy and Interpersonal Therapy is also exposed.

2. Psychotherapy less effective than antidepressant medication

In line with the above, there are more than 20 investigations collected in the meta-analysis by Cruijpers, Berking et al. (2013), which is cited in the article by Sanz and García-Vera (2017) that proves the absence of difference in efficacy between CBT and the antidepressant drugs.

It is partially true that it has not been possible to demonstrate greater efficacy in other types of psychotherapeutic interventions other than CBT, for example in the case of Interpersonal Therapy, but no such conclusion can be applied to CBT. Therefore, this idea must be considered false.

3. The treatment of depression is long

In El Mundo it is stated that the treatment of severe depression should be at least one year due to the frequent recurrences that are associated with the course of this type of disorder. Despite the fact that scientific knowledge agrees with establishing a high recurrence rate (between 60 and 90% according to Eaton et al., 2008), they also show that there is an approach in brief psychological therapy (based on CBT) that has a significant rate of efficacy for depression. These interventions range from 16 to 20 weekly sessions.

The aforementioned meta-analyses indicate a duration of 15 sessions (Johnsen and Friborg) or between 8-16 sessions (Cruijpers et al.). Therefore, such initial hypothesis must be considered false based on the data presented in the reference article.

4. The psychologist is not the professional who treats depression

According to the writing group of El Mundo, it is the psychiatrist who carries out the intervention on patients with depression; the psychologist can take care of pictures of depressive symptoms, of a milder nature than the depressive disorder per se. Two conclusions can be drawn from this statement that have already been refuted previously.: 1) depression is a biological disease that can only be addressed by a psychiatrist and 2) the psychological intervention may only be effective in cases of mild or moderate depression, but not in cases of depression serious.

In the original text by Sanz and García-Vera (2017) some more misconceptions than those presented in this text can be found. This becomes a clear example of the increasingly common trend to publish information that is not sufficiently scientifically proven. This can lead to a significant risk since today any type of information is is within the reach of the general population, causing biased or insufficient knowledge validated. Such danger is even more disturbing when it comes to health issues.

Bibliographic references:

• Sanz J. And García-Vera, M.P. (2017) Misconceptions about Depression and its Treatment (I and II). Papers of the Psychologist, 2017. Vol 38 (3), pp 169-184.
• Editorial office of CuidatePlus (2016, October 1). Misconceptions about depression. Recovered from http://www.cuidateplus.com/enfermedades/psiquiatricas/2002/04/02/ideas-equivocadas-depresion-7447.html
• Writing of DMedicina (2015, September 8). Misconceptions about depression. Recovered from http://www.dmedicina.com/enfermedades/psiquiatricas/2002/04/02ideas-equivocadas-depresion-7447.html