Laurie Barclay, MD
NEW YORK (MedscapeWire) May 24 Cognitive therapy and antidepressants are equally effective for initial treatment of severe depression, but the enduring effect of cognitive therapy may prove to be more cost-effective in the long run.
These controversial findings were presented at a symposium on May 23 at the American Psychiatric Association annual meeting in Philadelphia, Pennsylvania. “This will be a surprising, controversial finding for many psychiatric professionals,” principal investigator Robert J. DeRubeis, MD, from the University of Pennsylvania, said in a news release.
“Most believe quite strongly in the efficacy of medication, and psychiatric treatment guidelines call unequivocally for medication in cases of severe depression.”
Compared with earlier studies of severely depressed patients requiring hospitalization, this randomized controlled study was significantly larger, involving 240 patients in Philadelphia and Nashville, Tennessee.
The study duration of 16 months was also considerably longer. After 4 months of acute treatment, patients who showed improvement in the initial phase underwent an additional year of treatment. Both study phases were placebo controlled.
“We looked at depression somewhat differently than prior studies,” said co-author Steven D. Hollon, PhD, from Vanderbilt University in Nashville. “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?’ “
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