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Tavistock adult depression study

The Tavistock adult depression etudy (TADS) is the first randomized controlled trial in the NHS to establish if long term psychoanalytic psychotherapy provides relief for patients living with chronic depression not helped by the treatments currently provided: antidepressants, short-term courses of counselling or cognitive behavioural therapy.

Clinical experience and existing research suggests that psychoanalytic therapies work, but this study tests the effectiveness of psychoanalytic psychotherapy using this most rigorous of scientific designs. The treatment tested is provided weekly over 18 months, as a treatment for persistent, chronic or treatment resistant depression.

Psychoanalytic psychotherapy sets out to address the personal and psychological issues which are thought to underlie chronic depression.

Status

  • 44% of the patients who were given 18 months of weekly psychoanalytic psychotherapy no longer have major depressive disorder when followed up two years after therapy had ended; for those receiving the NHS treatments currently provided the figure was only 10%.
  • Whilst just 14% of those receiving the psychoanalytic psychotherapy had recovered completely, full recovery occurred in only 4% of those receiving the treatments currently employed
  • In every 6-months period of the trial’s exceptional 3 ½ years of observation of participants, the chances of going into partial remission for those receiving psychoanalytic psychotherapy were 40% higher than for those who were receiving the usual treatments.
  • After two years of follow-up, depressive symptoms had partially remitted in 30% of those receiving the psychoanalytic therapy; in the control condition this figure was again only 4%.
  • Those receiving the psychoanalytic psychotherapy also saw significantly more benefits to their quality of life, general wellbeing and social and personal functioning.
  • Some patients did not benefit. Research is ongoing to identify the reasons underlying the differences in responsiveness.

The TADS started in 2002. Recruitment into the trial ended in March 2010 and the treatment/review period was completed in December 2011. The two-year follow-up period took place in December 2013. The outcome findings have been published in World Psychiatry: The paper was published in the open access journal World Psychiatry