Cognitive Therapy and Pharmacotherapy for Depression: Singly and in Combination

doi:10.1001/archpsyc.1992.01820100018004

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Vol. 49 No. 10, October 1992

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Cognitive Therapy and Pharmacotherapy for Depression

Singly and in Combination

Steven D. Hollon, PhD; Robert J. DeRubeis, PhD; Mark D. Evans, PhD; Marlin J. Wiemer, PhD; Michael J. Garvey, MD; William M. Grove, PhD; Vicente B. Tuason, MD, FRCPC

Arch Gen Psychiatry. 1992;49(10):774-781.

Abstract

• Cognitive therapy and imipramine hydrochloride tricyclicpharmacotherapy, each singly and in combination, were comparedin the treatment of nonpsychotic, nonbipolar depressed outpatients.One hundred seven patients were randomly assigned to 12 weeksof active treatment; 64 patients completed the full course oftreatment. Rates of attrition were high but not differential.Cognitive therapy and pharmacotherapy did not differ in termsof symptomatic response, either in the primary analyses or insecondary analyses restricted to more severely depressed outpatients.Initial severity did predict response within pharmacotherapyalone, but not within cognitive therapy. Combining cognitivetherapy with pharmacotherapy did not markedly improve responseover that observed for either modality alone, although suchnonsignificant differences as were evident did favor the combinedtreatment. Two patients died as a consequence of suicide attempts,both of which involved study medication.

Author Affiliations

From the Department of Psychology, University of Minnesota, Minneapolis (Drs Hollon, DeRubeis, Evans, and Grove), and Department of Psychiatry, St Paul (Minn)-Ramsey Medical Center (Drs Wiemer, Garvey, and Tuason). Dr Hollon is now with the Department of Psychology, Vanderbilt University, Nashville, Tenn; Dr DeRubeis, with the Department of Psychology, University of Pennsylvania, Philadelphia; Dr Garvey, with the Veterans Affairs Medical Center and the Department of Psychiatry, University of Iowa College of Medicine, Iowa City; and Dr Tuason, with the Veterans Affairs Medical Center and the Department of Psychiatry, University of New Mexico, Albuquerque.

Footnotes

Accepted for publication June 18, 1992.

Read in part before the 141st Annual Meeting of the AmericanPsychiatric Association, Montreal, Quebec, May 12, 1988.

Reprint requests to Department of Psychology, Vanderbilt University,306 Wilson Hall, Nashville, TN 37240 (Dr Hollon).

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