Following a publication in El Mundo (digital version) in 2015 in the several misconceptions about depressive disorder. Sanz and García-Vora (2017), of the Complutense University of Madrid, carried out an exhaustive review on this subject in order to shed light on the veracity of the information contained in this text (and many others that today can be found on countless psychology web pages or blogs). And it is that in many cases, these data do not seem to be based on proven scientific knowledge.
Below is a list of the conclusions allegedly accepted and published by the editorial board of the DMedicina portal (2015), the same group of specialists that does the editing in El Mundo. These ideas refer both the nature of depressive psychopathology as well as the efficacy indices of psychological interventions which are applied for their treatment.
Misconceptions About Depressive Disorder
As for the misconceptions about depression itself, we find the following.
1. When everything is going well in life, you can get depressed.
Contrary to what was published in the El Mundo article, according to the scientific literature, this statement should be considered partially false, as the results indicate that the relationship between previous life stressors and depression is stronger than expected. In addition, depression has a connotation of illness, which leads to attributing greater biological than environmental causation. On the latter, science indicates that there are a small number of cases of depression without a history of external stress.
2. Depression is not a chronic illness that never goes away
De Mundo’s article views depression as a condition that never goes away at all, even if the arguments behind it are not entirely true.
First, the wording in question indicates that the rate of effectiveness of the pharmacological intervention is 90%, in a multitude of meta-analyzes carried out over the last decade (Magni et al. 2013; Leutch, Huhn and Leutch 2012 ; Omari et al. 2010; Cipriani, Santillian et al. 2009) give an approximate percentage of 50 to 60% effectiveness in psychiatric treatment, Depending on the drug used: SSRIs or tricyclic antidepressants.
On the other hand, the authors of the review article add that in the conclusions of a recent meta-analysis (Johnsen and Friborg, 2015) on 43 analyzed studies, 57% of patients in total remission were reached after a cognitive intervention. behavioral, so that it can be established a similar efficacy index between pharmacological and psychotherapeutic prescription empirically validated.
3. No one pretends to be depressed to quit their job
The wording of the portal indicates that it is very difficult to trick the professional into faking depression, so there are hardly any cases of fake depression. However, Sanz and García-Vora (2017) present the data obtained in several surveys in which the depression simulation percentages can vary from 8 to 30%The latter result in cases where workers’ compensation is tied.
Thus, although it may be considered that a greater proportion of the population visited in primary care does not simulate this psychopathology, the assertion that there is no case where this casuistry does not occur cannot be considered valid.
4. Optimistic and outgoing people are as or more depressed than those who are not.
The article we are discussing argues for the idea that because of the greater emotional intensity of optimistic and extroverted people, they are more likely to suffer from depression. On the other hand, the list of studies presented by Sanz and García-Vora (2017) in their text indicates precisely the opposite. These authors cite the meta-analysis by Kotov, Gamez, Schmidt and Watson (2010) where lower rates 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, as corroborated by studies such as those of Giltay, Zitman and Kromhout (2006) or Vickers and Vogeltanz (2000).
Misconceptions About Depressive Disorder Treatment
These are other mistakes you might fall into when thinking about psychotherapeutic treatments for depressive disorders.
1. Psychotherapy does not cure depression
According to El Mundo’s article, there is no study showing that psychological intervention allows depression to subside, although it does assume that it may be effective in the presence of certain milder depressive symptoms, such as those shown in adaptive disorder. Thus, he argues that the only effective treatment is pharmacological.
Data obtained in the analysis by Cuijpers, Berking et al (2013) indicate the opposite of this finding, as they found that cognitive behavioral therapy (CBT) it was significantly higher than the wait list or usual treatment (Composed of various psychotropic drugs, psychoeducation sessions, etc.).
In addition, the data provided previously on the study by Johnsen and Friborg (2015) corroborates the falsity of this initial statement. The text also outlines the proven effectiveness of studies of behavioral activation therapy and interpersonal therapy.
2. Psychotherapy is less effective than antidepressants
In accordance with the above, there are more than 20 surveys collected in the meta-analysis by Cruijpers, Berking et al (2013), which is cited in the article by Sanz and García-Vora (2017) which proves the absence difference in efficacy between CBT and antidepressants.
It is partly 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 such a conclusion cannot be applied to CBT. Therefore, this idea must be considered false.
3. The treatment of depression takes a long time
El Mundo says that treatment for severe depression should last at least a year because of the frequent recurrences associated with the course of this type of disorder. If scientific knowledge shows their agreement to establish a high percentage of recurrences (between 60 and 90% according to Eaton et al., 2008), they also show that there is a brief approach to psychological therapy (Based on CBT) which has a significant efficacy index for depression. These interventions range from 16 to 20 weekly sessions.
The meta-analyzes mentioned above indicate a duration of 15 sessions (Johnsen and Friborg) or between 8-16 sessions (Cruijpers et al.). Therefore, such an initial assumption should 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 editorial team of El Mundo, it is the psychiatrist who performs the intervention of patients suffering from depression; the psychologist may be dealing with images of depressive symptoms, which are milder in nature than the depressive disorder itself. From this statement are drawn two conclusions which have already been refuted above.: 1) depression is a biological disease that can only be treated by a psychiatrist and 2) psychological intervention can only be effective in mild to moderate depression, but not in severe depression.
In the original text by Sanz and García-Vora (2017), it is possible to consult more misconceptions than those presented in this text. This is becoming a clear example of the growing tendency to publish information that is not sufficiently scientifically proven. This can lead to a significant risk because today any type of information is available to the general population resulting in biased or insufficiently validated knowledge. Such a danger is even more worrying when it comes to problems of health.
- Sanz J. and García-Vera, MP (2017) Misconceptions about depression and its treatment (I and II). Psychologist Papers, 2017. Vol 38 (3), pages 169-184.
- Written by CuidatePlus (2016, October 1). Misconceptions about depression. Retrieved from http://www.cuidateplus.com/enfermedades/psiquiatricas/2002/04/02/ideas-equivocadas-depresion-7447.html
- Writing of DMedicina (2015, September 8). Misconceptions about depression. Retrieved from http://www.dmedicina.com/enfermedades/psiquiatricas/2002/04/02ideas-equivocadas-depresion-7447.html