The Process of Change in Cognitive Therapy and Pharmacotherapy for Depression: Changes in Mood and Cognition

doi:10.1001/archpsyc.1984.01790120049007

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Vol. 41 No. 1, January 1984

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The Process of Change in Cognitive Therapy and Pharmacotherapy for Depression

Changes in Mood and Cognition

Anne D. Simons, PhD; Sol L. Garfield, PhD; George E. Murphy, MD

Arch Gen Psychiatry. 1984;41(1):45-51.

Abstract

• Twenty-eight moderately depressed outpatients were randomlyassigned to 12 weeks of cognitive therapy (N =14) or pharmacotherapy(N =14). Significant changes in mood, cognitive processes, andcontent were similar to those found in previous studies demonstratingeffectiveness of cognitive therapy. Patients treated with medication,however, demonstrated nearly identical change on all measures,including cognitive measures, despite the absence of directfocus on cognitive activity. Further analyses disclosed thatcognitive change may be an important feature of overall clinicalimprovement, as patients whose conditions did not improve (regardlessof treatment modality) showed significantly less change on cognitivemeasures. These findings suggest that cognitive change may bemore accurately seen as a part of improvement rather than theprimary cause of improvement. This suggests a more complex conceptualizationof the role of cognitions in the change secured by cognitivetherapy.

Author Affiliations

From the Departments of Psychiatry (Drs Simons and Murphy) and Psychology (Dr Garfield), Washington University School of Medicine, St Louis. Dr Simons is now with the University of Pittsburgh Western Psychiatric Institute and Clinic.

Footnotes

Accepted for publication April 8, 1983.

Reprint requests to Western Psychiatric Institute and Clinic,3811O'hara St, Pittsburgh, PA 15213 (Dr Simons).

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