Four potential criteria for deciding when to use antidepressants or psychotherapy for unipolar depression: A literature review

Objective: To evaluate the literature supporting four potential criteria for deciding whether to use psychotherapy or pharmacology when treating depression. Method: Literature review of the evidence from the last 10 years on presenting patient's demographics, aetiology, comorbidity, and genetic factors, as predictors of treatment outcome efficacy. Results: Demographic information has little support as a potential criteria for decision-making; aetiology (melancholic vs. non-melancholic) has significant support; presence of personality disorder comorbidity is unproven as a criterion but may have some value; genetic predisposition has the strongest evidence supporting it as a criteria for treatment decision-making. Conclusion: Although some presenting cases will be easier to classify than others, there are substantial data supporting the screening of patients according to three of these criteria.