Remission in Major Depressive Disorder: A Comparison of Pharmacotherapy, Psychotherapy, and Control Conditions

Are antidepressants and psychotherapy equally effective in treating depression? A critical commentary

“…Several comparator trials and meta-analyses have attempted to compare antidepressants and psychotherapy to determine which might provide more symptom relief, typically using clinician-rated symptom inventories such as the Hamilton Rating Scale for Depression (HRSD). By and large, the results of these meta-analyses indicate that short-term acute treatment of major depressive disorder yields equivalent results on average between pharmacotherapy and psychotherapy (Casacalenda et al, 2002;Cuijpers et al, 2008Cuijpers et al, , 2013aHuhn et al, 2014;Imel et al, 2008;Spielmans et al, 2011), and pharmacological treatment may be superior to psychotherapy in the treatment of dysthymia (Cuijpers et al, 2008(Cuijpers et al, , 2013bImel et al, 2008). Further, a meta-analysis of trials comparing psychotherapy to pill placebo (Cuijpers et al, 2014b) yielded an overall therapy-placebo effect size comparable to the effect sizes found in meta-analyses of antidepressant-placebo differences (Kirsch et al, 2008;Sugarman et al, 2014;Turner et al, 2008).…”

CBT in Affective Disorders – New Frontiers

“…Placebo-controlled studies that compared the efficacy of cognitive behavior therapy (CBT) with that of antidepressant medication (ADM) found out that CBT is as efficacious as ADM in the treatment of patients with mild to severe forms of depression and that both treatments are superior to placebos [3][4][5]. Spoken numerically, about 40-60% of the patients respond to a CBT treatment [6].…”

Managing complex problems: treatment for common mental disorders in the UK

“…There appears little difference in the effects of particular treatments, either in terms of drug types, or the active and goal-oriented psychotherapies (cognitive, behavioural, or interpersonal) (Robinson et al, 1990), and only limited benefits from combinations of either different drugs or of drugs and talking treatments. These approaches appear effective for many of those treated, with response rates for depressed patients in the region of 60% and remission rates around 10% lower (Casacalenda et al, 2002). But, the findings of repeated studies are that for a sizeable proportion of depressed patients, response to treatments is likely to be suboptimal.…”