title: Similar changes in cognitions following cognitive-behavioral therapy or escitalopram for major depressive disorder: Implications for mechanisms of change.
abstract: BACKGROUND
  Psychosocial treatments and medications both have been shown to be effective in treating major depressive disorder. We hypothesized that cognitive-behavioral therapy (CBT) would outperform medication on measures of cognitive change.
  
  
  METHODS
  We randomized depressed individuals to 12 weeks of CBT (n = 15) or escitalopram (n = 11). In an intent-to-treat analysis (n = 26), we conducted a repeated measures analysis of variance to examine changes in depressive symptoms (ie, 17-item Hamilton Depression Rating Scale, Beck Depression Inventory), anhedonia (ie, Snaith-Hamilton Pleasure Scale), cognitive measures (ie, Dysfunctional Attitudes Scale, Automatic Thoughts Questionnaire, Perceived Stress Scale), and quality of life (ie, Quality of Life Enjoyment and Satisfaction Questionnaire) at 4 time points: baseline, week 4, week 8, and week 12. Treatment for both groups started at baseline, and patients received either 12 weeks of individual CBT or 12 weeks of escitalopram with flexible dosing (10 to 20 mg).
  
  
  RESULTS
  Collapsing the escitalopram and CBT groups, there were statistically significant pre-post changes on all outcome measures. However, there were no statistically significant differences between treatment groups on any of the outcome measures, including cognitive measures across time points.
  
  
  CONCLUSIONS
  Our results suggest that both CBT and escitalopram have similar effects across a variety of domains and that, in contrast to our a priori hypothesis, CBT and escitalopram were associated with comparable changes on cognitive measures.
authors.affiliation: Depression Clinical and Research Program, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA. E-mail: afarabaugh@partners.org.
authors.forename: Amy
authors.initials: A
authors.lastname: Farabaugh
authors.forename: Lauren
authors.initials: L
authors.lastname: Fisher
authors.forename: Maren
authors.initials: M
authors.lastname: Nyer
authors.forename: Daphne
authors.initials: D
authors.lastname: Holt
authors.forename: Mariana
authors.initials: M
authors.lastname: Cohen
authors.forename: Lee
authors.initials: L
authors.lastname: Baer
authors.forename: Benjamin G
authors.initials: BG
authors.lastname: Shapero
authors.forename: Ilana
authors.initials: I
authors.lastname: Huz
authors.forename: Amber
authors.initials: A
authors.lastname: Cardoos
authors.forename: Maurizio
authors.initials: M
authors.lastname: Fava
authors.forename: Jonathan E
authors.initials: JE
authors.lastname: Alpert
mesh_terms: D000328:Adult; D000368:Aged; D015283:Citalopram / Q000008:administration & dosage / Q000494:pharmacology*; D003072:Cognition Disorders / Q000188:drug therapy / Q000209:etiology / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome
chemical_list: D015283:Citalopram; D017367:Selective Serotonin Reuptake Inhibitors