The DOI matches its Crossref record, with a small difference in title or year; 36 of the 36 references it cites were found in a registry or an index.
National Institute of Mental Health Treatment of Depression Collaborative Research Program: General Effectiveness of Treatments
Abstract
We investigated the effectiveness of two brief psychotherapies, interpersonal psychotherapy and cognitive behavior therapy, for the treatment of outpatients with major depression disorder diagnosed by Research Diagnostic Criteria. Two hundred fifty patients were randomly assigned to one of four 16-week treatment conditions: interpersonal psychotherapy, cognitive behavior therapy, imipramine hydrochloride plus clinical management (as a standard reference treatment), and placebo plus clinical management. Patients in all treatments showed significant reduction in depressive symptoms and improvement in functioning over the course of treatment. There was a consistent ordering of treatments at termination, with imipramine plus clinical management generally doing best, placebo plus clinical management worst, and the two psychotherapies in between but generally closer to imipramine plus clinical management. In analyses carried out on the total samples without regard to initial severity of illness (the primary analyses), there was no evidence of greater effectiveness of one of the psychotherapies as compared with the other and no evidence that either of the psychotherapies was significantly less effective than the standard reference treatment, imipramine plus clinical management. Comparing each of the psychotherapies with the placebo plus clinical management condition, there was limited evidence of the specific effectiveness of interpersonal psychotherapy and none for cognitive behavior therapy. Superior recovery rates were found for both interpersonal psychotherapy and imipramine plus clinical management, as compared with placebo plus clinical management. On mean scores, however, there were few significant differences in effectiveness among the four treatments in the primary analyses. Secondary analyses, in which patients were dichotomized on initial level of severity of depressive symptoms and impairment of functioning, helped to explain the relative lack of significant findings in the primary analyses. Significant differences among treatments were present only for the subgroup of patients who were more severely depressed and functionally impaired; here, there was some evidence of the effectiveness of interpersonal psychotherapy with these patients and strong evidence of the effectiveness of imipramine plus clinical management. In contrast, there were no significant differences among treatments, including placebo plus clinical management, for the less severely depressed and functionally impaired patients.
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“although CBT did not fare as well as IPT or antidepressant medication among the more severely depressed patients in this study.”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Elkin et al., 1989
In the citing paper
“Outcomes for CBT and interpersonal therapy were generally equivalent (Elkin et al., 1989)”
From The empirical status of cognitive-behavioral therapy: A review of meta-analyses (2006) · cites this paper as Elkin et al., 1989
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“These beliefs are supported by evidence from individual studies (Paykel et al., 1988; Elkin et al., 1989; Angst et al., 1993) and from two other meta-analyses (Ottevanger, 1993; Khan et al., 2002).”
ResultThe Value of Maintenance Interpersonal Psychotherapy (IPT) in Older Adults With Different IPT Foci
Miller, M. D., Frank, E., Cornes, C. L., Houck, P. R., & Reynolds, C. F. (2003) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200301000-00013 · Cited by 37
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“Our findings are also, to some extent, consistent with the NIMH collaborative study (Elkin et al., 1989) and the Sheffield study (Shapiro et al., 1994).”
BackgroundResultInfluentialA randomized pilot study of anger treatment for Iraq and Afghanistan veterans
Shea, M. T., Lambert, J., & Reddy, M. K. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.05.013 · Cited by 36
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MethodCan research influence clinical practice?
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“Blatt and Shahar (2004) reanalysed the results of the Menninger project (which was unable to distinguish between the outcomes of psychoanalysis and psychoanalytic psychotherapy) and those of the NIMH TDCRP (which also failed to demonstrate differences in the effi cacy of cognitive–behavioural and interpersonal therapi…”
MethodTucker, J. A., & Reed, G. M. (2008) · Rehabilitation Psychology · doi:10.1037/a0012963 · Cited by 35
“For example, a comparison of cognitive therapy and medication for depressed patients in which the cognitive therapy appeared to have been poorly implemented concluded that its effects were inferior to those of medication (Elkin et al., 1989).”
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BackgroundSudden Gains Can Occur in Psychotherapy Even When the Pattern of Change Is Gradual
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“…that psychopathology severity, which is thought to be a marker of greater genetic loading for the disorder, often indicates the need for more intensive intervention strategies or combination therapies (e.g., DeRubeis et al., 2005; Elkin et al., 1989; Khan, Brodhead, Kolts, & Brown, 2005).”
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“…by Hedges’ Lower Upper Pharma support Study g Limit Limit P Bedi et al (2000)24 Blackburn & Moore (1997)25 David et al (2008)28 Dunlop et al (2012)32 Elkin et al (1989)34 Faramarzi et al (2008)35 Hegerl et al (2010)38 Hollon et al (1992)39 McLean & Hakstian (1979)46 Menchetti et al (2014)47 Mohr…”
BackgroundThe transdiagnostic process of perfectionism
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“The NIMH Treatment of Depression Collaborative Research Program (TDCRP) was the first placebo-controlled comparison of drugs and psychotherapy in the treatment of MDD; there were no differences among patients with less severe depressions,[7] but among patients with more severe depressions both ADM and interpersonal ps…”
MethodTober, G., Clyne, W., Finnegan, O., Farrin, A. J., & Ian Russell Team (2008) · Alcohol and Alcoholism · doi:10.1093/alcalc/agn064 · Cited by 34
“Project MATCH (Project MATCH Research Group, 1997) used a similar rating system to the TDCRP depression study.”
MethodThe Structure of Competence: Evaluating the Factor Structure of the Cognitive Therapy Rating Scale
Goldberg, S. B., Baldwin, S. A., Merced, K., Caperton, D. D., Imel, Z. E., Atkins, D. C., & Creed, T. A. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.05.008 · Cited by 34
“…studies relied on relatively modest amounts of data drawn primarily from the National Institute of Mental Health Treatment of Depression Collaborative Research Program (NIMH TDCRP; Elkin et al., 1989), while the more recent study (Creed et al., 2016) was conducted in a larger community sample.”
MethodMollon, P. (2009) · Psychodynamic Practice · doi:10.1080/14753630802614457 · Cited by 34
“One of the largest and most sophisticated outcome studies – the National Institute of Mental Health Collaborative Study of the treatment of depression (Elkin et al., 1989) compared four approaches: Beck’s Cognitive Therapy, Klerman & Wiessman’s Interpersonal Therapy, antidepressant medication, and…”
MethodInterpersonal psychotherapy (IPT) in major depressive disorder
Brakemeier, E., & Frase, L. (2012) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-012-0357-0 · Cited by 34
“The response rates have been compared with other psychotherapies, placebo, and medication [4, 6], and follow-up relapse rates have been examined [11].”
BackgroundIntegrating Research Ethics into the Introductory Psychology Course Curriculum
Fisher, C. B., & Kuther, T. L. (1997) · Teaching of Psychology · doi:10.1207/s15328023top2403_4 · Cited by 34
“…case study drew attention to ethicalissues associatedwithrandomized clinical trials (RCT) research with participants with psychological disorders (Elkin et al., 1989). fied three fundamental ethical principles as relevant to research with human participants: (a) beneficence (promotion Critical…”
BackgroundInterpersonal processes affecting early alliance formation in experiential therapy for depression
Wong, K. K. Y., & Pos, A. E. (2012) · Psychotherapy Research · doi:10.1080/10503307.2012.708794 · Cited by 34
“These criteria ensured that severely depressed, functionally impaired clients were excluded (Elkin et al., 1989).”
BackgroundDistorted Packaging: Marketing Depression as Illness, Drugs as Cure
Gardner, P. M. (2003) · Journal of Medical Humanities · doi:10.1023/a:1021314017235 · Cited by 34
“The most comprehensive study to date of antidepressant effectiveness conducted for the NIMH by Elkin et al. (1989), compared cognitive-behavioral therapy, interpersonal psychotherapy, antidepressants, and placebo over a sixteen-week period.”
BackgroundListening to meta-analysis but hearing bias.
Klein, D. F. (1998) · Prevention & Treatment · doi:10.1037/1522-3736.1.1.16c · Cited by 34
The future of psychotherapy integration.
Goldfried, M. R., & Castonguay, L. G. (1992) · Psychotherapy · doi:10.1037/0033-3204.29.1.4 · Cited by 34
Constraints on Antidepressant Prescribing and Principles of Cost-Effective Antidepressant Use
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Psychotherapy in the Maintenance Treatment of Depression
Weissman, M. M. (1994) · The British Journal of Psychiatry · doi:10.1192/s0007125000293288 · Cited by 34
Psychological Treatments for Depression An Update
Scott, J. L. (1995) · The British Journal of Psychiatry · doi:10.1192/bjp.167.3.289 · Cited by 33
Will improving detection of depression in primary care lead to improved depressive outcomes?
Katon, W. J. (1995) · General Hospital Psychiatry · doi:10.1016/0163-8343(94)00055-i · Cited by 34
Interpersonal psychotherapy for depression with panic spectrum symptoms: a pilot study
Cyranowski, J. M., Frank, E., Shear, M. K., Swartz, H. A., Fagiolini, A. M., Scott, J., & Kupfer, D. J. (2005) · Depression and Anxiety · doi:10.1002/da.20069 · Cited by 33
“%) achieved remission of MDD, with a median time to remission of 12.2 weeks (95% CI¼ 9.7–21.0 weeks).”
BackgroundInfluentialCorbisiero, S., Bitto, H., Newark, P. E., Mörstedt, B., Elsässer, M., Buchli-Kammermann, J., Künne, S., Nyberg, E., Fallahpour, M. H., & Stieglitz, R. (2018) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2018.00571 · Cited by 33
Recent Developments in the Treatment of Depression
Hollon, S. D., Cohen, Z. D., Singla, D. R., & Andrews, P. W. (2019) · Behavior Therapy · doi:10.1016/j.beth.2019.01.002 · Cited by 37
Brown, J. S. L., Elliott, S. A., Boardman, J., Andiappan, M., Landau, S., & Howay, E. (2007) · Depression and Anxiety · doi:10.1002/da.20365 · Cited by 32
“%) occurred at the 3-month follow-up stage, a rate which is comparable with attrition rates of 41.1% [Scott and Stradling, 1990] and 32% [Elkin et al., 1989] found in other depression studies.”
InfluentialComparison of specific and nonspecific factors in a group cognitive therapy for depression.
Oei, T., & Shuttlewood, G. (1997) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(97)00019-0 · Cited by 36
Crits-Christoph, P. F., Gibbons, M. B. C., Temes, C. M., Elkin, I., & Gallop, R. (2010) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0019549 · Cited by 33
“The role of therapeutic alliance in psychotherapy and pharmacotherapy outcome: Findings in the National Institute of Mental Health Treatment of Depression Collaborative Research Program.”
MethodInfluentialSelf-citationPrescriptive Authority for Psychologists
McGrath, R. E. (2010) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-090209-151448 · Cited by 36
Highet, N. J., & Drummond, P. D. (2004) · Australian & New Zealand Journal of Psychiatry · doi:10.1080/j.1440-1614.2004.01342.x · Cited by 33
“Behavioural intervention in the present study encompassed mastery events, pleasant event scheduling and relaxation, and replicated the efficacy of this form of treatment for general depression [1].”
ResultRobertson, M. S., Rushton, P. J., Bartrum, D., & Ray, R. (2004) · International Journal of Group Psychotherapy · doi:10.1521/ijgp.54.2.145.40384 · Cited by 33
“…modality in a series of treatment trials for depression, most notably the National Institute of Mental Health Treatment of Depression Collaborative Research Trial, where it was shown to be equal in efficacy to cognitive therapy and Imipramine in acute treatment of depression (Elkin et al., 1989).”
MethodPutnam, K., McKibbin, L., & Wachs, J. E. (2004) · AAOHN Journal · doi:10.1177/216507990405200309 · Cited by 35
Ekeblad, A., Falkenström, F., Andersson, G., Vestberg, R., & Holmqvist, R. (2016) · Depression and Anxiety · doi:10.1002/da.22495 · Cited by 33
“Thus, existing studies suggest that the differences in effect between IPT and CBT in the treatment of depression are likely to be small.[6, 10, 12, 14] It is, however, important to test the relative effectiveness of these treatments in different treatment contexts.”
BackgroundMethodResultPredictors of Treatment Change and Engagement in Cognitive-Behavioral Group Therapy for Depression
Westra, H. A., Dozois, D. J. A., & Boardman, C. (2002) · Journal of Cognitive Psychotherapy · doi:10.1891/jcop.16.2.227.63996 · Cited by 38
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“Several clinical trials have documented the efficacy of IPT for major depression (12,13).”
BackgroundMethodDependency, matching adversities, length of survival and relapse in major depression
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PREDICTORS OF TREATMENT OUTCOMES AMONG DEPRESSED WOMEN WITH CHILDHOOD SEXUAL ABUSE HISTORIES
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“[5, 6, 15–17] In the Treatment of Depression Collaborative Research Program (TDCRP),[18] patients with low socioeconomic status (SES; i.”
“Dwelling in the Past”: The Role of Rumination in the Treatment of Posttraumatic Stress Disorder
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“…more depression-oriented treatment such as cognitive therapy (e.g., Teasdale, Fennell, Hibbert, & Amies, 1984), behavioral activation (e.g., Dimidjian et al., 2006), interpersonal psychotherapy (e.g., Elkin et al., 1989), or even a more rumination-focused intervention (e.g., McEvoy & Perini, 2009).”
BackgroundDie Wirksamkeit psychodynamischer Psychotherapie
Shedler, J. (2011) · Psychotherapeut · doi:10.1007/s00278-011-0819-2 · Cited by 32
“…Studien, die dafür ausgelegt sind, manualisierte Behandlungen zu vergleichen, interagieren Therapeuten mit Patienten auf unterschiedliche Art und Weise, implementieren Interventionen unterschiedlich und führen Prozesse ein, die in den Behandlungsmanualen nicht aufgeführt sind (Elkin et al. 1989).”
BackgroundAn Open Pilot Study of Interpersonal Psychotherapy for Panic Disorder (IPT-PD)
Lipsitz, J. D., Gur, M., Miller, N. L., Forand, N. R., Vermes, D., & Fyer, A. J. (2006) · The Journal of Nervous and Mental Disease · doi:10.1097/01.nmd.0000221302.42073.a1 · Cited by 32
Measuring Learning in Depression Treatment: A Cognitive Bibliotherapy Test
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The efficacy of psychotherapy in non‐bipolar depression: a review
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Type 1 diabetes structured education: what are the core self‐management behaviours?
Grant, L. M., Lawton, J., Hopkins, D., Elliott, D., Lucas, S. S., Clark, M., MacLellan, I., Davies, M., Heller, S. R., & Cooke, D. D. (2013) · Diabetic Medicine · doi:10.1111/dme.12164 · Cited by 31
Continuation-phase cognitive therapy's effects on remission and recovery from depression.
Vittengl, J. R., Clark, L. A., & Jarrett, R. B. (2009) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0015238 · Cited by 31
“, low HRSD scores) at the end of ACT (e.g., DeRubeis et al., 2005; Dimidijian et al., 2006; Elkin et al., 1989).”
BackgroundWang, J. T., Hoffman, B. M., & Blumenthal, J. A. (2010) · Expert Opinion on Pharmacotherapy · doi:10.1517/14656566.2010.513701 · Cited by 30
Social inhibition as a mediator of neuroticism and depression in the elderly
Wongpakaran, N., Wongpakaran, T., & van Reekum, R. (2012) · BMC Geriatrics · doi:10.1186/1471-2318-12-41 · Cited by 38
Wampold, B. E., Mondin, G. W., Moody, M., & Ahn, H.-N. (1997) · Psychological Bulletin · doi:10.1037/0033-2909.122.3.226 · Cited by 31
PSYCHOTHERAPY FOR DYSTHYMIC DISORDER
Markowitz, J. C. (1996) · Psychiatric Clinics of North America · doi:10.1016/s0193-953x(05)70278-1 · Cited by 31
Impact of separation anxiety on psychotherapy outcomes for adults with anxiety disorders
Kirsten, L. T., Grenyer, B. F. S., Wagner, R., & Manicavasagar, V. L. (2008) · Counselling and Psychotherapy Research · doi:10.1080/14733140801892620 · Cited by 31
Psychodynamic interpersonal therapy
Guthrie, E. (1999) · Advances in Psychiatric Treatment · doi:10.1192/apt.5.2.135 · Cited by 31
Acceleration of change: Catalysts in brief therapy
Eckert, P. A. (1993) · Clinical Psychology Review · doi:10.1016/0272-7358(93)90022-e · Cited by 31
Severity of unipolar depression and choice of treatment
McLean, P. D., & Taylor, S. J. (1992) · Behaviour Research and Therapy · doi:10.1016/0005-7967(92)90028-f · Cited by 31
Behavioral Activation Treatment for Depression: A Commentary
Hollon, S. D. (2001) · Clinical Psychology Science and Practice · doi:10.1093/clipsy.8.3.271 · Cited by 31
Diagnosis and Treatment of Depression in General Practice
FREELING, P. (1993) · The British Journal of Psychiatry · doi:10.1192/s0007125000292313 · Cited by 31
“Many practitioners believe that a combination of drug and 'talking treatment' is in fact most suitable, and this is consonant with the work of Elkin et al (1989), who found imipramine combined with 'clinical management' more effective than interpersonal psychotherapy, cognitive behaviour therapy,…”
BackgroundMethodResultTreatment of Major Depression in Later Life: A Life Cycle Perspective
Reynolds, C. F. (1997) · Psychiatric Quarterly · doi:10.1023/a:1025484123244 · Cited by 31
Ambrosini, P. J., BIANCHI, M. D., RABINOVICH, H., & Elia, J. (1993) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/00004583-199305000-00001 · Cited by 31
Late-Life Atypical Major Depressive Episode: A 358-Case Study In Outpatients
Benazzi, F. (2000) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200005000-00006 · Cited by 31
Pharmacologic Treatment of Child and Adolescent Depression
Kye, C., & Ryan, N. D. (1995) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/s1056-4993(18)30433-4 · Cited by 31
The applied use of psychotherapy in the study of the psychobiology of depression.
Thase, M. E., & Simons, A. D. (1992) · PubMed Central · Cited by 31
Ormsby, S., Smith, C. A., Dahlen, H. G., & Hay, P. (2020) · Journal of Affective Disorders · doi:10.1016/j.jad.2020.05.089 · Cited by 33
Banon, E., Perry, J. C., Semeniuk, T., Bond, M., de Roten, Y., Hersoug, A. G., & Despland, J.-N. (2013) · Psychotherapy Research · doi:10.1080/10503307.2012.745955 · Cited by 27
“Nevertheless, our findings of convergence between CBT and dynamic therapies are in agreement with Ablon and Jones (1999, 2002), who found significant overlap between CBT and interpersonal therapy in the NIMH treatment of depression study (Elkin et al., 1989) and Goldsamt, Goldfried, Hayes and Jerr (1992), who found th…”
BackgroundResultCraigie, M. A., & Nathan, P. (2009) · Behavior Therapy · doi:10.1016/j.beth.2008.08.002 · Cited by 38
Tolin, D. F. (2017) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2017.08.007 · Cited by 25
Metadata
- Authors
- Elkin, I.
- Affiliations
- National Institutes of Health (US)
- Corresponding author
- Elkin, Irene
- Venue
- Archives of General Psychiatry
- Publisher
- American Medical Association (AMA)
- Published
- 1989-11-01
- Volume
- 46
- Issue
- 11
- Pages
- 971
- ISSN
- 0003-990X (ISSN-L)
- OpenAlex
- W2169217816
- Cited by
- 2,300
- References
- 36
- Citations by year
- 2026: 14 · 2025: 17 · 2024: 22 · 2023: 19 · 2022: 17 · 2021: 23 · 2020: 71 · 2019: 29 · 2018: 30 · 2017: 34 · 2016: 74 · 2015: 71 · 2014: 52 · 2013: 84 · 2012: 80
- FWCI
- 71.65
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of General Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH 33762, MH-33760, MH33753)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- major depressive disorder, interpersonal psychotherapy, cognitive behavioral therapy, imipramine, antidepressant treatment, brief psychotherapy, outpatients, treatment effectiveness, depression severity, functional disability, placebo response, subgroup analysis
- MeSH terms
- Adult, Ambulatory Care, Combined Modality Therapy, Depressive Disorder, Female, Humans, Imipramine, Male, National Institute of Mental Health (U.S.), Outcome and Process Assessment, Health Care, Placebos, Psychiatric Status Rating Scales, Psychotherapy, United States, Multicenter Studies as Topic, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic
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