Study: cognitive therapy as good as medication, but lasts longer

Wednesday, April 6, 2005A landmark study comparing effectiveness in reducing major depression of two forms of initial treatment — cognitive therapy which involves discussing thought processes with a qualified counselor, vs medication — has revealed that both forms of therapy reduce depression, but that the benefits of cognitive therapy last longer than those of medication. The study finding contradicts current treatment guidelines of the American Psychiatric Association (APA).

The 16-week study, by researchers at the University of Pennsylvania and Vanderbilt University, was the largest trial yet undertaken to resolve the years-old debate. Two-hundred-and-forty patients with moderate-to-severe depression were given one or other of the treatments, or a purposely-ineffective placebo. Study representatives described the two treatments about equally effective — both much more effective than the placebo — but with the positive effect of talk-therapy lasting longer.

In fact, the cognitive therapy group saw only as many relapses as a another group that had continued to receive drug therapy.

“We believe that cognitive therapy might have more lasting effects because it equips patients with the tools they need to learn how to manage their problems and emotions,” said Robert DeRubeis, professor and chair of Penn’s Department of Psychology. “Pharmaceuticals, while effective, offer no long term cure for the symptoms of depression. For many people, cognitive therapy might prove to be the preferred form of treatment.”

“Medication is often an appropriate treatment, but drugs have drawbacks, such as side effects or a diminished efficacy over time,” DeRubeis said. “Patients with depression are often overwhelmed by other factors in their life that pills simply cannot solve. In many cases, cognitive therapy succeeds because it teaches the skills that help people cope.”

Researchers pointed out that while the effectiveness of cognitive therapy depended largely on the experience of the practitioner, the same was true of medication, due to the judgement required in prescribing correct dosages of drugs.

The APA declined to comment, on the basis that a quote appearing on Wikinews could be distorted by subsequent edits of the article.