Major depressive disorder affects nearly 15 million of American adults in a given year. (Kessler, Chiu, Demler & Walters, 2005). With the impact it has on the society as well as the well-being of the individual, it must be in the interest of the healthcare to be able to provide patients with the most effective treatment method. Extensive research has been conducted on the efficacy of antidepressant medication and cognitive therapy, the two main treatment methods used for depression today. The discussion has, however, been characterized by conflicting claims, resulting in a debate over what should be used rather than us having definite conclusion of how patients are best helped.
The extensive research of Elkin et al (1989) concluded that cognitive therapy was not an effective treatment method for severely depressed outpatients. This had a major impact on the treatment guidelines of The Agency for Health Care Policy and Research, resulting in medications becoming generally favored at the time. These results, the quality of the therapy provided as well as the conclusions drawn have, however, been questioned by contradicting research which instead argue that cognitive therapy is just as effective in the treatment of depression. Hollon et al (1992) conducted a randomized trial which displayed both treatment methods as effective, with a non-significant difference of efficacy. Murphy, Carney, Knesevich, Wetzel and Whitworth (1995) also designed a trial which displayed similar results between the treatment methods while the research conducted by Blackburn & Moore (1997) indicated that cognitive therapy was superior to medications in the maintenance phase of treatment.
A high number of studies as well as the current treatment guidelines seem to conclude that the efficacy of cognitive therapy is just as high as for antidepressant medication. There is, however, discrepancy between the results, and in this review a closer look will be taken at more recent research and what the results suggest.
Five randomized trials conducted from the year 2000 and onwards were selected. The primary database used for searching was PsycINFO. Keywords used include “cognitive therapy”, “psychotherapy”, “antidepressants”, “medication”, “psychopharmaca”, “depression treatment” and “depressive disorder”.
In research conducted by Hollon et al (2005), it was stated that while there was evidence for the enduring effects of cognitive therapy, there was a lack of extensive research comparing the effects to the use of antidepressant medication after terminating the treatment.
In the study, 180 patients meeting the criterias for severe and major depression were assigned to either one of the treatment methods. Of these, 104 met the response criteria and were included in a 12 month continuation phase and constitute the main focus of the study. Patients who had responded to the therapy were withdrawn and followed up during a 12-month period. Those who had...