Cognitive therapy combined with antidepressant medication improved recovery rates compared with medication alone, but only among patients with severe nonchronic depression, found a randomized trial of 452 adults with major depressive disorder (Hollon S et al. JAMA Psychiatry. doi:10.1001/jamapsychiatry.2014.1054 [published online August 20, 2014]).
Patients with chronic or recurrent major depressive disorder (MDD) were randomly assigned to receive medication alone or combined with cognitive therapy. Treatment was administered for up to 42 months or until recovery was achieved. The rate of recovery was greater with combined treatment than with medication alone (72.6% vs 62.5%), but the benefit was apparent only in patients with severe (score >22 on the 17-item Hamilton Rating Scale for Depression), nonchronic (episode duration <2 years) MDD (81.3% vs 51.7%). Remission rates were high and didn’t significantly differ with either treatment. The combined therapy group had fewer serious adverse events than patients who received antidepressant medications alone (49 vs 71), mainly because their MDD episodes were shorter.
Slomski A. Combined Therapy May Enhance Recovery Rates of Severe Depression. JAMA. 2014;312(16):1624. doi:10.1001/jama.2014.13117