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Depression affects about 7% to 18% of the population at some point in their lives (Bland, 1997) and there is evidence that the overall prevalence of depression is rising despite increased use of antidepressants (Moncrieff & Kirsch, 2005). Several forms of psychosocial therapy have shown to be successful options for treating moderate to severe depression. However, whether psychosocial treatments are as effective as medications has long been debated between the psychiatric and psychological communities. Psychiatrists are traditionally considered to support medication treatments, while clinical psychologists are viewed as advocates of psychotherapy (Eells, 1999). Antidepressant medications are the most common form of treatment for major depression (Olfson et al., 2002), and are considered the standard treatment by the American Psychiatric Association (2000). Yet, reviews comparing the efficacy of pharmacotherapy to psychosocial therapies have yielded conflicting conclusions, with some studies concluding that psychotherapy is less effective than medication in treating severe depression (e.g., Elkin et al., 1995; Thase & Friedman, 1999), while others state that psychotherapy is the superior long-term treatment (e.g., Antonuccio et al., 1995; Tang et al., 2007).
Abnormal neurotransmitter levels and inadequate neurotransmission are regarded as major causes of depression (Richards & Perri, 2002), and these two components are the targets of antidepressant medications. Both the APA’s “Practice Guideline for the Treatment of Patients with Major Depressive Disorder” and the UK’s National Institute of Health and Clinical Excellence (NICE) recommend that patients with moderate to severe depression be offered antidepressants as a first-line treatment (American Psychiatric Association, 2000; McAllister-Williams & Ferrier, 2006), and there is evidence supporting the efficacy of these medications for the treatment of acute, moderate to severe depression (DeRubeis et al.,...