Depression Research

Many research projects since the 1970’s have examined the effectiveness of

cognitive and behavioral treatments of depression. Beck and his colleagues

have demonstrated that cognitive therapy for depression is superior to no

treatment whatsoever and to placebos (inactive psychological or medical interventions

which should have no real effect but which the patient believes

have therapeutic value). In addition, this research has shown that cognitive

therapy is about as effective as both antidepressant medications and behavior

therapy. Similarly, Lewinsohn and others have shown the effectiveness of

behavior therapy on depression by demonstrating that it is superior to no

treatment and to placebo conditions.

One of the most important studies of the treatment of depression is the

Treatment of Depression Collaborative Research Program, begun by the

National Institute of Mental Health (NIMH) in the mid-1980’s. Members of

a group of 250 clinically depressed patients were randomly assigned to one

of four treatment conditions: interpersonal psychotherapy, cognitive behavioral

psychotherapy, tricyclic antidepressant medication, and placebo medication.

Treatment was presented over sixteen to twenty sessions. Patients

were assessed by both self-report and a clinical evaluator before treatment,

after every fourth session, and at six-, twelve-, and eighteen-month followups

after the end of treatment.

This study found that patients in all four treatment conditions improved

significantly over the course of therapy. In general, patients who received

antidepressant medication improved the most, patients who received the

placebo improved the least, and patients who received the two forms of psychotherapy

improved to an intermediate degree (but were closer in improvement

to those receiving antidepressant medication than to those receiving

the placebo). This study also found that, for patients in general,

there was no significant difference between the effectiveness rates of the antidepressant

medication and the two forms of psychotherapy.

For severely depressed patients, however, antidepressant medication and

interpersonal psychotherapy were found to be more effective than other

treatments; for less severely depressed patients, there were no differences in

effectiveness across the four treatment conditions.