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Cognitive therapy plus medication management is better than antidepressants alone for patients with severe depression
  1. Sharon C Sung
  1. Correspondence to Dr Sharon C Sung, Office of Clinical Sciences, Duke-NUS Graduate Medical School Singapore, 20 College Road, Level 6, Singapore 169856, Singapore; sharon.sung{at}

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ABSTRACT FROM: Hollon SD, DeRubeis RJ, Fawcett J, et al. Effect of cognitive therapy with antidepressant medications vs antidepressants alone on the rate of recovery in major depressive disorder: a randomised clinical trial. JAMA Psychiatry 2014;71:1157–64.

What is already known on this topic

Antidepressant medications (ADM) and cognitive therapy (CT) are recommended as first-line treatments for major depressive disorder (MDD), on the basis of clinical trials of relatively brief duration.1 Real-world clinical practice, however, typically involves multiple medication trials and strategies for combining, augmenting or switching to other medications or CT until remission is reached. The present study addresses this limitation by examining a principle-driven algorithm for providing ADM alone versus ADM combined with CT (ADM plus CT) in a sample of adult outpatients treated for up to 42 months.

Methods of the study

This randomised study consisted of 452 outpatients (aged 18 years or over) with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) chronic or recurrent MDD recruited at three US research centres. Patients with Axis I psychiatric comorbidity, imminent suicide risk, …

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  • Competing interests None declared.