Study: Cognitive therapy at least as effective as drugs in treating severe depression

PHILADELPHIA A new study indicates that cognitive therapy is at least as effective as medication for long-term treatment of severe depression, and it is less expensive. The findings, by researchers at the University of Pennsylvania and Vanderbilt University, undercut opinions now held by many in the psychiatric profession.

Principal investigators Robert J. DeRubeis of Penn and Steven D. Hollon of Vanderbilt and their colleagues will present the work Thursday, May 23 at the annual conference of the American Psychiatric Association in Philadelphia.

"This will be a surprising, controversial finding for many psychiatric professionals," said DeRubeis, professor and chair of psychology at Penn. "Most believe quite strongly in the efficacy of medication, and psychiatric treatment guidelines call unequivocally for medication in cases of severe depression."

Compared to past research on severely depressed patients those depressed nearly enough to require hospitalization DeRubeis and Hollons study was unusually comprehensive in its size, 240 patients in Philadelphia and Nashville, and in its duration, 16 months.

"We looked at depression somewhat differently than prior studies," said Hollon, professor of psychology at Vanderbilt. "The question that has most often been asked in studies is, What gets people better faster? We asked, What will keep depression away over the long term?"

The study by DeRubeis, Hollon and colleagues involved a four-month period of acute treatment followed by an additional year of treatment for those who showed improvement in the initial phase. Among those who continued into the second phase of the study, 75 percent of patients who underwent cognitive therapy avoided a relapse, compared to 60 percent of patients on medication and 19 percent of those receiving a placebo pill.

"Statistically, both cognitive therapy and medication were more effective than a placebo, and a brief course of cognitive

Contact: Steve Bradt
University of Pennsylvania

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