Dysthymia in clinical practice :psychological therapies.

Psychological therapies for depression may have several different targets: symptom amelioration, relapse prevention, and improving social adaptation. For cognitive therapy the targets are mainly the first two of these, for dynamic psychotherapies particularly the third. In dysthymia, provision of a coping repertoire for a long term illness may also be important. There have been few controlled trials of psychological therapies in dysthymia, but one study has found benefit from marital therapy, and uncontrolled studies, suggest some benefit from cognitive therapy. Controlled trials in other forms of depression of specific targeted psychotherapies, most commonly interpersonal psychotherapy, but also group, marital and family therapy, and social work, show benefit on social adjustment and some benefit on symptoms. Controlled trials of cognitive therapy show symptom benefit in milder depression, and strongly suggestive evidence of relapse reduction.