ABSTRACT
INTRODUCTION Major depressive disorder (MDD) is one of the world’s greatest public health problems (1), and in industrialized nations, it is the leading cause of disability (2). Theoretical and clinical approaches to the treatment of depression have changed greatly since the psychoanalytic models of treatment dominated the psychiatric landscape in the mid-20th century. Seminal developments in the 1950s and 1960s included recognition that several distinctly different types of medication had antidepressant effects, which ultimately shaped the influential monoamine hypotheses of depression and helped to define treatment for the decades to come. Concurrently, the pioneering work of Beck (cognitive therapy; CT), Klerman and Weisman (interpersonal psychotherapy; IPT), and other psychotherapy researchers led to the introduction of several time-limited, operationalized forms of psychosocial intervention specifically developed to treat depression. As understanding of the etiology, pathophysiology, and risk factors of MDD continued to grow over the next three decades, additional pharmacological and psychosocial therapies have been introduced. This chapter is designed to provide a framework to help understand the contemporary biopsychosocial approach to treatment of depressive disorders, including brief reviews of the current evidence base that guides the acute and longer-term phases of treatment.
