ABSTRACT

Introduction Cognitive therapy (CT) of depression (Beck et al. 1979) was described as a method of treatment for out-patients with mild to moderate depressions. All published controlled studies of efficacy have so far included only out-patients, usually satisfying research diagnostic critieria for major or definite depression (Spitzer et al. 1978; Feighner et al. 1972), unipolar subtype. Seven studies have compared CT with antidepressant medication, each alone or in combination (Rush et al. 1977; Beck et al. 1979; Blackburn et al. 1981; Rush and Watkins 1981; Murphy et al. 1984; Teasdale et al. 1984; Beck et al. 1985). The results of these treatment trials have all confirmed the efficacy of CT in the treatment of depression, CT being found equivalent or superior to antidepressant medication. Other studies have compared CT with behaviour therapy in the treatment of depressed self-referred students and media-recruited depressed individuals. These studies (Shaw 1977; Taylor and Marshall 1977; Zeiss et al. 1979; Wilson et al. 1983) have found CT superior or equivalent to behaviour therapy and superior to waiting-list controls. Various other studies (e.g. McLean and Hakstian 1979; Shipley and Fazio 1973) have used behaviour therapy with a strong cognitive component in depressed out-patients or depressed students, and found cognitive behaviour therapy to be an effective treatment, superior to psychodynamic or supportive psychotherapy.