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.