Sequence of improvement in depressive symptoms across cognitive therapy and pharmacotherapy

BackgroundThe authors examined the patterns of improvement in cognitive and vegetative symptoms of major depression in individuals treated with cognitive therapy (CT) or pharmacotherapy (PT).MethodOutpatients diagnosed with major depressive disorder (n = 180) were randomized to receive either CT or PT. Cognitive and vegetative symptoms of major depression were measured by the Beck Depression Inventory-II at baseline and regularly throughout 16 weeks of treatment.ResultsMultivariate hierarchical linear modeling demonstrated the same patterns of change over time for cognitive and vegetative symptoms within CT and within PT.LimitationsSelf-report measures may not be sufficiently specific to capture subtle differences in improvements between vegetative and cognitive symptoms.ConclusionsThese results are consistent with Beck's [Beck, A.T., 1984, November. Cognition and theory [Letter to the editor]. Arch. Gen. Psychiatry 41, 1112–1114.] hypothesis that CT and PT have a similar site of action, which when targeted, results in changes in both cognitive and vegetative features.