Changes in well-being and quality of life in a randomized trial comparing dynamic psychotherapy and pharmacotherapy for major depressive disorder

Sigal Zilcha-Mano, Ulrike Dinger, Kevin S. McCarthy, Marna S. Barrett, Jacques P. Barber

Research output: Contribution to journalArticlepeer-review


Background Major depressive disorder (MDD) is associated with a decrease in quality of life (QOL) and well-being. Therefore, researchers are increasingly complementing traditional symptom measurements with QOL and well-being assessments in order to broaden the evaluation of treatment outcomes. The current prospective study investigated the effectiveness of supportive- expressive therapy (SET), antidepressant medication (MED) and placebo (PBO) in improving QOL and well-being in patients with MDD. Methods Data from a randomized controlled trial (trial registration: NCT00043550) comparing SET, MED and PBO for the treatment of depression (N=156) were analyzed. Outcome measures addressed patients' QOL and physical and mental well-being. Changes in outcomes were assessed across and between treatments using linear mixed models. Results Across treatments, patients showed significant improvement in QOL and mental and physical health measures, as well as a reduction in interpersonal distress and depressive and anxiety symptoms (p≤.002 for all measures). Those changes were not only the products of a decrease in depressive symptoms, but also predicted subsequent reduction in symptoms. No significant differences were found between the three treatment conditions. Limitations The limitation is the study's moderate sample size. Conclusions Current treatments for depression significantly improve patients' QOL and well-being. No significant differences were found between the three conditions examined in this study. The current study highlights the role of well-being in predicting subsequent symptomatic change.

Original languageEnglish
Pages (from-to)538-542
Number of pages5
JournalJournal of Affective Disorders
Issue number1
StatePublished - Jan 2014
Externally publishedYes

Bibliographical note

Funding Information:
Dr. Zilcha-Mano has received funding from the Fulbright Program. Dr. Barber has received funding from the National Institute of Mental Health (NIMH), and the National Institute on Drug Abuse (NIDA); authors' fees from Guilford Press, Basic Books, and Cambridge University Press; and honoraria from Lundbeck. The other authors declare no conflict of interest.

Funding Information:
The original study was conducted with support from NIMH grant R01 MH 061410 to J.P. Barber (P.I.). The sertraline and pill placebos were provided by a grant from Pfizer Corp. The current study was written with support from the Fulbright Program to S. Zilcha-Mano.


  • Depression
  • Psychodynamic psychotherapy
  • Quality of life
  • Secondary outcomes
  • Well-being

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology


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