Specific Psychological Distress: Depression

This section covers depression from both a practical clinical and a research perspective. See the UK directory for help with finding the right therapist to work with depression.

Specific Psychological Distress


Beck, A.T.; A.J. Rush, B.F. Shaw and G. Emery (1979) Cognitive Therapy of Depression. New York: Guilford.

This is the classic treatment manual for depression from the cognitive therapy perspective, from the creator of the field and his colleagues. Also see Clark and Beck (1999).

Berkman, L.F. et al. (2003) 'Effects of Treating Depression and Low Perceived Social Support on Clinical Events After Myocardial Infarction: The Enhancing Recovery in Coronary Heart Disease Patients (ENRICHD) Randomized Trial', Journal of the American Medical Association 289 :3106-16.

Several studies have indicated a correlation between depression and post-MI morbidity and mortality, but this large-scale (2481 patients) study set out to examine whether interventions specifically intended to address depression and low perceived social support (LPSS) could reduce the excess risk for MI sufferers. After an average follow-up of 29 months, there was no significant difference in terms of survival between the control group and the intervention group; the latter received a median of 11 sessions of CBT, as well as anti-depressants (SSRIs) when indicated. Nancy Frasure-Smith and Francois Lesperance, in an editorial on the study appearing in the same issue, refer to it as "the largest controlled trial of psychotherapy ever completed."

Clark, D.A. and A.T. Beck (1999) Scientific Foundations of Cognitive Theory and Therapy of Depression. New York: John Wiley.

This far-reaching review strongly supports the cognitive theory of depression that dysfunctional thinking helps exacerbate and maintain depression.

Dawson, A. and A. Tylee, eds. (2001) Depression: Social and Economic Timebomb. London: BMJ Books.

This proceedings volume from an international meeting on unipolar depression run by the World Health Organization contains up-to-date contributions on depression in a global context including economic and societal consequences, history, depression in the workplace, and the treatment of depression in general practice. It includes a useful debate on whether SSRIs (selective serotonin reuptake inhibitors) should be considered the most effective first-line treatment for depression.

Kessler, R.C. et al. (2003) 'The Epidemiology of Major Depressive Disorder: Results From the National Comorbidity Survey Replication (NCS-R)', Journal of the American Medical Association 289 (23): 3095-3105.

This survey of over 9000 US adults reveals a lifetime prevalence rate for Major Depressive Disorder of over 16%, with fewer than 22% of sufferers receiving adequate levels of treatment. Around three quarters had comorbid mental health disorders.

Richards, S. and M.G. Perri (2002) Depression: A Primer for Practitioners. London: Sage.

Aimed at a wide range of those who deal with people who are depressed (including counsellors, psychiatrists and psychologists, general practice physicians and social workers), this somewhat dry book provides an overview of the latest material on depression. It is well described by the authors as "a combination of 'scholarly book' plus 'how-to book'" (p. xi). It includes sections on the symptomatology of depression and theories about treatment, on depression in various age groups, on comorbidity and other problems associated with depression, and on treatment (the last including individual chapters on psychotherapy, pharmacotherapy and relapse prevention). Psychotherapeutic treatment and theory discussions particularly emphasize cognitive behavioural therapy and interpersonal psychotherapy. UK readers won't help but notice the US-centricity of the content, but the book remains a valuable resource and perhaps the only current volume which achieves the goal of being an effective 'primer'. Also, it is likely that readers from any specific field (say, counselling or general medical practice, for instance) will be left wanting much more depth and detail -- however the book includes many specific recommendations for further reading which can act as a starting point for further exploring. Finally, chapter 8 on chronic health problems associated with depression -- and especially the association with cardiovascular disease in general and myocardial infarction in particular -- makes very sobering reading for just about anyone.

Stewart, W.F. et al. (2003) 'Cost of Lost Productive Work Time Among US Workers With Depression', Journal of the American Medical Association 289 (23): 3135-44.

This large-scale study indicates that US workers with depression report 5.6 hours per week of health-related lost productive time (LPT), versus 1.5 hours per week for workers without depression. 81% of the LPT costs are due to reduced performance while at work. The figures equate to a cost of some $44 billion worth of LPT in the US workforce due to depression, $31 billion more than workers not experiencing depression.

Üstün, T.B. and S. Chatterji (2001) 'Global Burden of Depressive Disorders and Future Projections', in Dawson and Tylee (2001), pp. 31-43.

Among other facts, this article observes (pp. 37-9) that the incidence and prevalance rates for depression included in the original GBD study (Murray and Lopez 1996) mean the GBD results are likely underestimates of the impact of depressive disorders. (Indeed, the figures cited suggest the GBD results may be massive understimates.)

Zheng, D.; C.A. Macera, J.B. Croft et al. (1997) 'Major Depression and All Cause Mortality Among White Adults in the United States', Annals of Epidemiology 7: 213-18.

Based on an analysis of the US National Health Interview Survey, and after adjusting for confounds such as age, marital status, education and body mass index, this study indicates that major depression significantly increases the risk of all-cause mortality, particularly among men.


This page was last reviewed by Dr Greg Mulhauser, Thursday, 3 November 2022.