Cognitive Therapy Plus Antidepressant Improves Depression Symptoms
http://www.psychiatryadvisor.com; August 22, 2014
Cognitive therapy (CT) along with taking an antidepressant leads to better outcomes than taking an antidepressant alone, although effect appears limited simply to patients struggling with severe depression that's not chronic.
Steven D. Hollon, PhD, of the Department of Psychology at Vanderbilt University, Nashville, Tennessee, and colleagues examined 452 adult outpatients with chronic or recurrent major depressive disorder (MDD), who have been randomly used on antidepressant treatment only or CT along with an antidepressant. Treatment was administered for about 42 weeks until recovery.
Combined treatment enhanced the pace of recovery vs. treatment having an antidepressant alone (72.6% vs 62.5%; t451= 2.45; P=0.01; hazard ratio, 1.33; 95% C: 1.06-1.68; number had to treat, 10; 95% CI: 5-72), the study reported in JAMA Psychiatry.
However, those results were conditioned on severity and chronicity of the depression, in ways that the advantage for combined treatment was limited by patients with severe, nonchronic MDD (81.3% vs. 51.7%; n=146; t145=3.96; P=0.001; HR, 2.34; 95% CI, 1.54-3.57; NNT, 3; 95% CI, 2-5).
Patients with comorbid Axis II disorders took longer to recuperate than did patients without comorbid Axis II disorders regardless with the condition (P=0.01). Also, patients who received combined treatment reported fewer serious adverse events than did patients who received antidepressants alone (49 vs. 71; P=0.02), largely because they experienced a shorter time in an MDD episode.
Antidepressant medication (ADM) is efficacious inside treatment of depression, although not all patients achieve remission and fewer still achieve recovery with ADM alone. The objective with the study is to determine the consequences of combining cognitive therapy with ADM vs ADM alone on remission and recovery in leading depressive disorder.