ORIGINAL RESEARCH article
Front. Psychiatry
Sec. Mood Disorders
Volume 16 - 2025 | doi: 10.3389/fpsyt.2025.1503848
The use of antidepressant medication affects change for depressed patients in open-ended psychotherapy in clinically representative conditions
Provisionally accepted
Andreas Høstmælingen1*
Helene Amundsen Nissen-Lie1
Jon Trygve Monsen1
Erkki Heinonen1
Bruce E Wampold2
Nikolai Czajkowski1
Endre Visted3Bjørn Lau1
Ole André Solbakken1- 1University of Oslo, Oslo, Norway
- 2University of Wisconsin-Madison, Madison, Wisconsin, United States
- 3University of Bergen, Bergen, Hordaland, Norway
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Objective: Depressed patients often experience both symptomatic distress and interpersonal problems. Comorbid personality disorder (PD) has been shown to attenuate the benefits of psychotherapy. Also, antidepressant medication (ADM) may affect the response to psychotherapy. The objective of this study was to investigate changes in depressive symptoms and interpersonal problems for ADM users and non-medicated depressed patients during psychotherapy and follow-up, controlling for comorbid PD. Method: Depressive symptoms (SCL-90-R), and interpersonal problems (IIP-64) were assessed on 11 occasions for 166 depressed patients. ADM was used by 50.6 % of the sample while 49.4 % were unmedicated. Change during treatment and follow-up was assessed with multilevel modeling. We assessed whether ADM and PD predicted differences in symptom development. Results: Depressive symptoms significantly reduced at a rate of .05 per month in treatment (p < .001), corresponding to an effect size of 1.35. Interpersonal problems significantly reduced at a rate of .02 per month during treatment (p < .001), corresponding to an effect size of .47. There was no significant difference between ADM users and nonmedicated patients at baseline. ADM users had nearly twice as long treatment duration than nonmedicated patients, and ADM users had lower rate of symptom reduction than nonmedicated patients for depressive symptoms and interpersonal problems. There were no differences in rates of change between patients with and without comorbid PD. Conclusion: Medicated patients may experience less response to psychotherapy in terms of depressive symptoms and interpersonal problems compared to nonmedicated patients.
Keywords: Depression, Psychotherapy, antidepressant medication, Interpersonal problems, Open ended treatment
Received: 29 Sep 2024; Accepted: 24 Jul 2025.
Copyright: © 2025 Høstmælingen, Nissen-Lie, Monsen, Heinonen, Wampold, Czajkowski, Visted, Lau and Solbakken. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Andreas Høstmælingen, University of Oslo, Oslo, Norway
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