Journal Mobile Options
Table of Contents
Vol. 76, No. 5, 2007
Issue release date: August 2007
Psychother Psychosom 2007;76:260–265

The Road to Recovery from Depression – Don’t Drive Today with Yesterday’s Map

Fava G.A. · Tomba E. · Grandi S.
aAffective Disorders Program and Laboratory of Experimental Psychotherapy, Department of Psychology, University of Bologna, Italy; bDepartment of Psychiatry, State University of New York at Buffalo, Buffalo, N.Y., USA

Individual Users: Register with Karger Login Information

Please create your User ID & Password

Contact Information

I have read the Karger Terms and Conditions and agree.

To view the fulltext, please log in

To view the pdf, please log in


The issue of recovery is getting increasing attention in depression research, particularly after the publication of the STAR*D results. The paper analyzes some issues which may hinder effective treatment of major depressive disorders: the inadequacies of a cross-sectional DSM assessment without clinical differentiation of the extent, development and seriousness of the disturbances (staging); over-emphasis on and prolongation of drug treatment, without paying attention to problems related to tolerance; neglect of the active role of the patient in achieving recovery, with the integration of psychotherapeutic strategies in a sequential model. If we are able to remove the conceptual obstacles which obstruct our view of depression and silence the sound of propaganda, we may then become aware of a different scenario in mood disorders and be able to develop therapeutic strategies of enduring quality.

Copyright / Drug Dosage

Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.


  1. Fava GA: The concept of recovery in affective disorders. Psychother Psychosom 1996;65:2–13.
  2. Fava GA, Ruini C, Belaise C: The concept of recovery in major depression. Psychol Med 2007;37:307–317.
  3. Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, Niederehe G, Thase ME, Lavori PW, Lebowitz BD, McGrath PJ, Rosenbaum JF, Sackheim HA, Kupfer DJ, Luther J, Fava M: Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps. Am J Psychiatry 2006;163:1905–1917.
  4. Fava M, Evins AE, Dorer DJ, Schoenfeld DD: The problem of the placebo response in clinical trials for psychiatric disorders. Psychother Psychosom 2003;72:115–127.
  5. Vieta E, Carnè X: The use of placebo in clinical trials on bipolar disorder. Psychother Psychosom 2005;74:10–16.
  6. Gaudiano BA, Herbert JD: Methodological issues in clinical trials of antidepressant medications. Psychother Psychosom 2005;74:17–25.
  7. Nelson JC: The STAR*D study: a four course meal that leaves us wanting more. Am J Psychiatry 2006;163:1864–1866.
  8. Fava GA, Kellner R: Staging. A neglected dimension in psychiatric classification. Acta Psychiatr Scand 1993;87:225–230.
  9. McGorry PD, Hichie IB, Yang AR, Pantelis C, Jackson HJ: Clinical staging of psychiatric disorders. Aust N Zeal J Psychiatry 2006;40:616–622.
  10. Fava GA, Tossani E: Prodromal stage of major depression. Early Intervention in Psychiatry 2007;1:9–18.

    External Resources

  11. Boyce P, Judd F: The place for tricyclic antidepressants in the treatment of depression. Aust N Zeal J Psychiatry 1999;33:323–327.
  12. Otto MW, Smits JAJ, Reese HE: Combined psychotherapy and pharmacotherapy for mood and anxiety disorders in adults: review and analyses. Clin Psychol Sci Pract 2005;12:72–86.

    External Resources

  13. Gaudiano BA, Miller IW, Herbert JD: The treatment of psychotic major depression: is there a role for adjunctive psychotherapy? Psychother Psychosom 2007;76:271–277.
  14. Fava GA, Ruini C, Rafanelli C: Psychometric theory is an obstacle to the progress of clinical research. Psychother Psychosom 2004;73:145–148.
  15. Fava GA: The intellectual crisis of psychiatric research. Psychother Psychosom 2006;75:202–208.
  16. Wise TN: Curiosity and crisis. Psychother Psychosom 2006;75:199–201.
  17. Benazzi F: Suicidal ideation and depressive mixed states. Psychother Psychosom 2005;74:61–62.
  18. Benazzi F: Is there continuity between bipolar and depressive disorders? Psychother Psychosom 2007;76:70–76.
  19. Ghaemi SN, Baldessarini RJ: The manic-depressive spectrum and mood stabilization. Psychother Psychosom 2007;76:65–69.
  20. De Fruyt J, Demyttenaere K: Bipolar (spectrum) disorder and mood stabilization. Psychother Psychosom 2007;76:77–88.
  21. Colom F, Vieta E: Sudden glory revisited: cognitive contents of hypomania. Psychother Psychosom 2007;76:278–288.
  22. Fava GA: Do antidepressant and antianxiety drugs increase chronicity in affective disorders? Psychother Psychosom 1994;61:125–131.
  23. Baldessarini RJ: Risks and implications of interrupting maintenance psychotropic drugs therapy. Psychother Psychosom 1995;63:137–141.
  24. Fava GA: Can long-term treatment with antidepressant drugs worsen the course of depression? J Clin Psychiatry 2003;64:123–133.
  25. Editorial sparks debate on effects of psychoactive drugs. Psychiatr News, May 20, 1994.
  26. Posternak MA, Zimmerman M: Dual reuptake inhibitors incur lower rates of tachyphylaxis than selective serotonin reuptake inhibitors. J Clin Psychiatry 2005;66:704–707.

    External Resources

  27. Fava M, Rush AJ: Current states of augmentation and combination treatments for major depressive disorder. Psychother Psychosom 2006;75:139–153.
  28. Moncrieff J, Cohen D: Rethinking models of psychotropic drug action. Psychother Psychosom 2005;74:145–153.
  29. Fava GA, Park SK, Sonino N: Treatment of recurrent depression. Exp Rev Neurother 2006;6:1735–1740.
  30. Fava GA, Sonino N: The clinical domains of psychosomatic medicine. J Clin Psychiatry 2005;66:849–855.
  31. Mokdad AH, Marks JS, Stroup DF, Gerberding JL: Actual causes of death in the United States, 2000. JAMA 2004;291:1238–1245.
  32. Andrews G: Should depression be managed as chronic disease? BMJ 2001;322:419–421.
  33. Narayan KMV, Kanaya AM, Gregg EW: Lifestyles interventions for the prevention of type 2 diabetes mellitus. Treat Endocrinol 2003;2:315–320.

    External Resources

  34. Frank JD, Frank JB: Persuasion and healing, ed 3. Baltimore, Johns Hopkins University Press, 1991.
  35. Fava GA: Cognitive-behavioral therapy; in Fink M (ed): Encyclopedia of Stress. San Diego, Academic Press, 2000, pp 484–487.
  36. Marks I, Dar R: Fear reduction by psychotherapies. Br J Psychiatry 2000;176:507–511.
  37. Marks IM: The maturing of therapy. Br J Psychiatry 2002;180:200–204.
  38. Fava GA, Rafanelli C, Grandi S, Conti S, Belluardo P: Prevention of recurrent depression with cognitive behavioral therapy. Arch Gen Psychiatry 1998;55:816–820.
  39. Paykel ES, Scott J, Teasdale JD, Johnson AL, Garland A, Moore R, Jenaway A, Cornwall PL, Hayhurst H, Abbott R, Pope M: Prevention of relapse in residual depression by cognitive therapy. Arch Gen Psychiatry 1999;56:829–835.
  40. Bockting CLH, Spinhoven P, Koeter MVT, Wounters LF, Schene AH: Differential predictors of response to preventive cognitive therapy in recurrent depression. Psychother Psychosom 2006;75:229–236.
  41. Kuehner C: An evaluation of the ‘Coping with depression course’ for relapse prevention with unipolar depressed patients. Psychother Psychosom 2005;74:254–259.
  42. Fava GA, Rafanelli C, Cazzaro M, Conti S, Grandi S: Well-being therapy. Psychol Med 1998;28:475–480.
  43. Lau MA, McCain SF: Integrating mindfulness meditation with cognitive and behavioral therapies. Can J Psychiatry 2005;50:863–869.
  44. Fava GA, Ruini C, Rafanelli C: Sequential treatment of mood and anxiety disorders. J Clin Psychiatry 2005;66:1392–1400.
  45. Blom MBJ, Jonker K, Dusseldorp E, Spinhoven P, Hoencamp E, Haffmans J, van Dyck R: Combination treatment for acute depression is superior only when psychotherapy is added to medication. Psychother Psychosom 2007;76:289–297.
  46. Fava GA, Ruini C, Rafanelli C, Finos L, Conti S, Grandi S: Six-year outcome of cognitive behavioral therapy for prevention of recurrent depression. Am J Psychiatry 2004;161:1872–1876.
  47. Zimmerman M, McGlinchey JB, Posternak MA, Friedman M, Attinlah N, Boerescu D: How should remission from depression be defined? Am J Psychiatry 2006;163:148–150.
  48. Ryff CD, Singer B: Psychological well-being. Psychother Psychosom 1996;65:14–23.
  49. Ryff CD, Dienberg-Love G, Urry HL, Muller D, Rosenkranz MA, Friedman EM, Davidson RJ, Singer B: Psychological well-being and ill-being. Psychother Psychosom 2006;75:85–95.
  50. Pasquali R: The biological balance between psychological well-being and distress. Psychother Psychosom 2006;75:69–71.
  51. Engel GL: A unified concept of health and disease. Persp Biol Med 1960;3:459–485.
  52. Fava GA: A different medicine is possible. Psychother Psychosom 2006;75:1–3.
  53. Cosgrove L, Krimsky S, Vijayaraghavan M, Schneider L: Financial ties between DSM-IV panel members and the pharmaceutical industry. Psychother Psychosom 2006;75:154–160.

Pay-per-View Options
Direct payment This item at the regular price: USD 38.00
Payment from account With a Karger Pay-per-View account (down payment USD 150) you profit from a special rate for this and other single items.
This item at the discounted price: USD 26.50