[Long-term treatment of depression: there is more than drugs].

Recent studies have emphasized the chronic nature of depressive disorder, and the need for endorsing the same treatment protocols used for other chronic disease, such as diabetes. But duration of treatment does not seem to affect long-term prognosis of patients with depression, once the drug is stopped. Despite treating depression effectively in the short-term, antidepressant drugs may worsen its course. Treatment of depression by pharmacological means is likely to leave residual symptoms in most patients. Such symptoms are important risk factors for relapse. In randomised controlled studies, cognitive behavioural treatment of residual symptoms significantly improved long-term outcome of recurrent depression. Indeed, depressive disorder has a chronic nature, but antidepressants are not the only possible treatment strategy. Cognitive-behavioral psychotherapy is an alternative, which is effective in engendering a complete and lasting recovery in patients with depression.