Can We Fight Depression?

If one enters the term "mood disorder" in the largest online medical database - Medline - you get close to 62,000 hits. If you restrict your search to randomized controlled trials, generally considered the most reliable design for investigating the efficacy of treatments, still more than 3,200 hits appear.

Considering the huge impact worldwide of depression on health, health care costs, and the ability to work, so much information should be good news. But look more closely at individual studies and it soon becomes obvious that most investigate physiological, metabolic, or biochemical disturbances associated with depression. None of these findings have been shown to be of any help for deciding which patients should be treated with what therapies over what period of time.

Of course, there are still roughly 1,500 studies of a multitude of treatments: psychopharmaceutical drugs, ECT, bright light, exercise, psychotherapies, and even acupuncture. True, many of these studies document the short-term, and in some cases the long-term, effects of various treatments, and generally with an acceptable trade-off between efficacy and safety.

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