Cognitive Therapy Versus Medication for Depression: Treatment Outcomes and Neural Mechanisms

Overview

Journal Nat Rev Neurosci

Specialty Neurology

Date 2008 Sep 12

PMID 18784657

Citations 218

Authors

Robert J DeRubeis

Greg J Siegle

Steven D Hollon

Affiliations

Soon will be listed here.

Abstract

Depression is one of the most prevalent and debilitating of the psychiatric disorders. Studies have shown that cognitive therapy is as efficacious as antidepressant medication at treating depression, and it seems to reduce the risk of relapse even after its discontinuation. Cognitive therapy and antidepressant medication probably engage some similar neural mechanisms, as well as mechanisms that are distinctive to each. A precise specification of these mechanisms might one day be used to guide treatment selection and improve outcomes.

Citing Articles

Behavioural and psychological factors associated with pre-frailty in community-dwelling adults aged 40 and over: a cross-sectional study.

Brennan T, Lewis L, Gordon S, Prichard I BMC Public Health. 2025; 25(1):956.

PMID: 40069744 PMC: 11895312. DOI: 10.1186/s12889-025-21957-4.

Duchenne muscular dystrophy: recent insights in brain related comorbidities.

Vaillend C, Aoki Y, Mercuri E, Hendriksen J, Tetorou K, Goyenvalle A Nat Commun. 2025; 16(1):1298.

PMID: 39900900 PMC: 11790952. DOI: 10.1038/s41467-025-56644-w.

TRPC4/5 inhibitors: Phase I results and proof of concept studies.

Grimm S, Just S, Fuertig R, Dwyer J, Sharma V, Wunder A Eur Arch Psychiatry Clin Neurosci. 2024; .

PMID: 39343822 DOI: 10.1007/s00406-024-01890-0.

The Importance of Psychotherapy for Treatment-Resistant Depression.

Ho D, Kim Y, Lim W Adv Exp Med Biol. 2024; 1456:257-271.

PMID: 39261433 DOI: 10.1007/978-981-97-4402-2_13.

Digital Mental Health Interventions for Alleviating Depression and Anxiety During Psychotherapy Waiting Lists: Systematic Review.

Huang S, Wang Y, Li G, Hall B, Nyman T JMIR Ment Health. 2024; 11:e56650.

PMID: 39255015 PMC: 11422735. DOI: 10.2196/56650.

References

de Mello M, de Jesus Mari J, Bacaltchuk J, Verdeli H, Neugebauer R . A systematic review of research findings on the efficacy of interpersonal therapy for depressive disorders. Eur Arch Psychiatry Clin Neurosci. 2005; 255(2):75-82. DOI: 10.1007/s00406-004-0542-x. View

Kazdin A . Developing a research agenda for child and adolescent psychotherapy. Arch Gen Psychiatry. 2000; 57(9):829-35. DOI: 10.1001/archpsyc.57.9.829. View

Saxena S, Brody A, Ho M, Alborzian S, Maidment K, Zohrabi N . Differential cerebral metabolic changes with paroxetine treatment of obsessive-compulsive disorder vs major depression. Arch Gen Psychiatry. 2002; 59(3):250-61. DOI: 10.1001/archpsyc.59.3.250. View

Ohira H, Nomura M, Ichikawa N, Isowa T, Iidaka T, Sato A . Association of neural and physiological responses during voluntary emotion suppression. Neuroimage. 2005; 29(3):721-33. DOI: 10.1016/j.neuroimage.2005.08.047. View

Shea M, Elkin I, Imber S, Sotsky S, Watkins J, Collins J . Course of depressive symptoms over follow-up. Findings from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Arch Gen Psychiatry. 1992; 49(10):782-7. DOI: 10.1001/archpsyc.1992.01820100026006. View

McClure E, Adler A, Monk C, Cameron J, Smith S, Nelson E . fMRI predictors of treatment outcome in pediatric anxiety disorders. Psychopharmacology (Berl). 2006; 191(1):97-105. DOI: 10.1007/s00213-006-0542-9. View

Mayberg H, Brannan S, Tekell J, Silva J, Mahurin R, McGinnis S . Regional metabolic effects of fluoxetine in major depression: serial changes and relationship to clinical response. Biol Psychiatry. 2000; 48(8):830-43. DOI: 10.1016/s0006-3223(00)01036-2. View

Blackburn I, Bishop S . Changes in cognition with pharmacotherapy and cognitive therapy. Br J Psychiatry. 1983; 143:609-17. DOI: 10.1192/bjp.143.6.609. View

Ramel W, Goldin P, Eyler L, Brown G, Gotlib I, McQuaid J . Amygdala reactivity and mood-congruent memory in individuals at risk for depressive relapse. Biol Psychiatry. 2006; 61(2):231-9. DOI: 10.1016/j.biopsych.2006.05.004. View

10.

Cohen J, Perlstein W, Braver T, Nystrom L, Noll D, Jonides J . Temporal dynamics of brain activation during a working memory task. Nature. 1997; 386(6625):604-8. DOI: 10.1038/386604a0. View

11.

Paquette V, Levesque J, Mensour B, Leroux J, Beaudoin G, Bourgouin P . "Change the mind and you change the brain": effects of cognitive-behavioral therapy on the neural correlates of spider phobia. Neuroimage. 2003; 18(2):401-9. DOI: 10.1016/s1053-8119(02)00030-7. View

12.

Sheline Y, Sanghavi M, Mintun M, Gado M . Depression duration but not age predicts hippocampal volume loss in medically healthy women with recurrent major depression. J Neurosci. 1999; 19(12):5034-43. PMC: 6782668. View

13.

Phillips M, Ladouceur C, Drevets W . A neural model of voluntary and automatic emotion regulation: implications for understanding the pathophysiology and neurodevelopment of bipolar disorder. Mol Psychiatry. 2008; 13(9):829, 833-57. PMC: 2745893. DOI: 10.1038/mp.2008.65. View

14.

Brody A, Saxena S, Silverman D, Alborzian S, Fairbanks L, Phelps M . Brain metabolic changes in major depressive disorder from pre- to post-treatment with paroxetine. Psychiatry Res. 2000; 91(3):127-39. DOI: 10.1016/s0925-4927(99)00034-7. View

15.

Ochsner K, Bunge S, Gross J, Gabrieli J . Rethinking feelings: an FMRI study of the cognitive regulation of emotion. J Cogn Neurosci. 2002; 14(8):1215-29. DOI: 10.1162/089892902760807212. View

16.

Chen C, Ridler K, Suckling J, Williams S, Fu C, Merlo-Pich E . Brain imaging correlates of depressive symptom severity and predictors of symptom improvement after antidepressant treatment. Biol Psychiatry. 2007; 62(5):407-14. DOI: 10.1016/j.biopsych.2006.09.018. View

17.

Davidson R . Affective style, psychopathology, and resilience: brain mechanisms and plasticity. Am Psychol. 2001; 55(11):1196-214. DOI: 10.1037//0003-066x.55.11.1196. View

18.

Evans M, Hollon S, DeRubeis R, Piasecki J, Grove W, Garvey M . Differential relapse following cognitive therapy and pharmacotherapy for depression. Arch Gen Psychiatry. 1992; 49(10):802-8. DOI: 10.1001/archpsyc.1992.01820100046009. View

19.

Siegle G, Steinhauer S, Thase M, Stenger V, Carter C . Can't shake that feeling: event-related fMRI assessment of sustained amygdala activity in response to emotional information in depressed individuals. Biol Psychiatry. 2002; 51(9):693-707. DOI: 10.1016/s0006-3223(02)01314-8. View

20.

Mayberg H . Positron emission tomography imaging in depression: a neural systems perspective. Neuroimaging Clin N Am. 2004; 13(4):805-15. DOI: 10.1016/s1052-5149(03)00104-7. View