The Addition of Cognitive Therapy to Antidepressants Improves Recovery Outcomes in Some Patients with Major Depression

In the October 2014 issue of JAMA Psychiatry, Hollon and collaborators published a randomized, not-blinded, up-to-42 months study in 452 adult outpatients with chronic or recurrent major depressive disorder (MDD). The trial compares antidepressant medications alone (AD) (n=227) with antidepressants medications + cognitive therapy (AD+CT). The authors found no differences between groups for remission rates, median time to remission, and relapse rates. The AD+CT group had higher recovery rates (defined as 26 consecutive weeks without relapse after remission) than the AD group, more specifically in patients with severe (74% vs. 54%) and non-chronic (77% vs. 60%) MDD. There were no differences in recovery rates between groups for patients with comorbid axis II disorder, chronic, or low-severity depression. These results suggest that only MDD patients with more severe, non-chronic, and no comorbid axis II disorders benefit from the addition of CBT to pharmacotherapy.