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: Amy Farabaugh, Lauren Fisher, Maren Nyer, Daphne Holt, Mariana Cohen, Lee Baer, Benjamin G Shapero, Ilana Huz, Amber Cardoos, Maurizio Fava, Jonathan E Alpert
• Journal: Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists (Ann Clin Psychiatry) Vol. 27 Issue 2 Pg. 118-26 (May 2015) ISSN: 1547-3325 [Electronic] United States
• PMID: 25954938 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Serotonin Uptake Inhibitors
• Citalopram

Topics

• Adult
• Aged
• Citalopram (administration & dosage, pharmacology)
• Cognition Disorders (drug therapy, etiology, therapy)
• Cognitive Behavioral Therapy (methods)
• Depressive Disorder, Major (complications, drug therapy, therapy)
• Female
• Humans
• Male
• Middle Aged
• Selective Serotonin Reuptake Inhibitors (administration & dosage, pharmacology)
• Treatment Outcome