Combined pharmacotherapy and psychotherapy in the treatment of mild to moderate major depression?

Treatment guidelines for major depressive disorders suggest that combined treatment of pharmacotherapy and psychotherapy may be helpful in the acute phase of severe major depression.1 However, combined treatment is not strongly recommended in mild to moderate depression. In these cases, either pharmacotherapy or psychotherapy can be used, depending on the preference of the patient, the treatment history, and other clinical factors. However, is this recommendation still supported by the current state of knowledge? In this Viewpoint, I will discuss recent evidence suggesting that combined treatment could be a first-line treatment in the acute phase of mild to moderate depressive disorders and whether this evidence is strong enough to reconsider the recommendations in treatment guidelines.