Sequence of improvement in depressive symptoms across cognitive therapy and pharmacotherapy.
BACKGROUND
The authors examined the patterns of improvement in cognitive and vegetative symptoms of major depression in individuals treated with cognitive therapy (CT) or pharmacotherapy (PT).


METHODS
Outpatients diagnosed with major depressive disorder (n=180) were randomized to receive either CT or PT. Cognitive and vegetative symptoms of major depression were measured by the Beck Depression Inventory-II at baseline and regularly throughout 16 weeks of treatment.


RESULTS
Multivariate hierarchical linear modeling demonstrated the same patterns of change over time for cognitive and vegetative symptoms within CT and within PT.


CONCLUSIONS
Self-report measures may not be sufficiently specific to capture subtle differences in improvements between vegetative and cognitive symptoms.


CONCLUSIONS
These results are consistent with Beck's [Beck, A.T., 1984, November. Cognition and theory [Letter to the editor]. Arch. Gen. Psychiatry 41, 1112-1114.] hypothesis that CT and PT have a similar site of action, which when targeted, results in changes in both cognitive and vegetative features.
Bhar
Sunil S
SS
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA. sbhar@mail.med.upenn.edu.au
Gelfand
Lois A
LA
Schmid
Sabine P
SP
Gallop
Robert
R
DeRubeis
Robert J
RJ
Hollon
Steven D
SD
Amsterdam
Jay D
JD
Shelton
Richard C
RC
Beck
Aaron T
AT
D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D017374:Paroxetine / Q000627:therapeutic use*; D010555:Personality Inventory; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016896:Treatment Outcome
D017374:Paroxetine; D017367:Selective Serotonin Reuptake Inhibitors