Differential change in specific depressive symptoms during antidepressant medication or cognitive therapy

Fournier J.C., DeRubeis R.J., Hollon S.D., Gallop R., Shelton R.C., Amsterdam J.D. Differential change in specific depressive symptoms during antidepressant medication or cognitive therapy. Behaviour Research and Therapy (in press).





This analysis of a large scale study of the effects of cognitive behavioral therapy and medications for major depression analyzed the effects of the two treatments on specific symptoms versus placebo. Medications affected a specific set of symptoms more than placebo, specifically negative thinking and suicidal ideation. Cognitive therapy on the other hand affected specific physical symptoms (for example, increased appetite, weight gain, and excessive sleep). These results indicate that medications and cognitive therapy work on different sets of depressive symptoms.

Ideally, these data can be used to tailor treatments to patients who exhibit specific sets of depressive symptoms. In particular, those with prominent physical symptoms may respond better to cognitive behavior therapy than medications, which is somewhat counterintuitive. By contrast, those with suicidal ideation responded more rapidly to medication.

This publication may help clinicians to select treatments for patients that are most likely to improve their depression.