Cognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators
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Synopsis Cognitive behavior therapy (CBT) is efficacious in the acute treatment of depression and may provide a viable alternative to antidepressant medications (ADM) for even more severely depressed unipolar patients when implemented in a competent fashion. CBT also may be of use as an adjunct to medication treatment for bipolar patients, although the studies are few and not wholly consistent. CBT does appear to have an enduring effect that protects against subsequent relapse and recurrence following the end of active treatment, something that cannot be said for medications. Single studies that require replication suggest that patients who are married or unemployed or who have more antecedent life events may do better in CBT than in ADM, as might patients who are free from comorbid Axis II disorders, whereas patients with comorbid Axis II disorders appear to do better in ADM than in CBT. There also are indications that CBT may work through processes specified by theory to produce change in cognition that in turn mediate subsequent change in depression and freedom from relapse following treatment termination, although evidence in that regard is not yet conclusive.
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Psychological treatments in general and CBT in particular appear to be equally effective for different subtypes of depression, including atypical, melancholic, and anxious depression.
“Psychological treatments in general and cognitive-behavioural therapy (CBT) in particular appear to be equally effective for different subtypes of depression, including atypical depression, melancholic depression, and anxious depression.9,10”
From Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder (2016) · cites this paper as [10]
In “CBT for severe depression” (page unavailable), the paper reports that cognitive therapy was as efficacious as phenelzine for atypical depression. In “Illness characteristics” (page unavailable), it says there is little evidence that melancholic depression responds less well to CBT than to medication. It does not establish equal effectiveness across the named subtypes, address anxious depression, or make that subtype-wide claim for psychological treatments generally. (LLM, conf=0.86)
Experimental — accuracy not yet measuredStrong evidence supports CBT for depression, anxiety, and pain-related disability.
“Substantial evidence supports the effectiveness of CBT for depression,17,21 anxiety,87 and pain and pain-related disability.93”
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References 107 · Cited by 291
Research works printed but not linked: 2
- [6]American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders Text Rev 2000 4th edition Washington DC American Psychiatric Association Press
- [7]Beck AT Rush AJ Shaw BF Cognitive therapy of depression 1979 New York Guilford Press
- Authors
- Driessen, E., & Hollon, S. D.
- Affiliations
- Vrije Universiteit Amsterdam (NL)
- Vanderbilt University (US)
- Corresponding author
- Driessen, Ellen
- Venue
- Psychiatric Clinics of North America
- Publisher
- Elsevier BV
- Published
- 2010-09
- Volume
- 33
- Issue
- 3
- Pages
- 537-555
- ISSN
- 0193-953X (ISSN-L)
- PMC
- PMC2933381
- OpenAlex
- W2068831405
- Semantic Scholar
- 456a5807584bd07fba9cc310969fc07df97dbd7b
- Cited by
- 291
- References
- 107
- Citations by year
- 2026: 7 · 2025: 8 · 2024: 14 · 2023: 25 · 2022: 26 · 2021: 32 · 2020: 18 · 2019: 18 · 2018: 20 · 2017: 15 · 2016: 24 · 2015: 23 · 2014: 19 · 2013: 18 · 2012: 11
- FWCI
- 1.69
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Psychiatric Clinics of North America (publishedVersion)
- PubMed (publishedVersion)
- VU Research Portal (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- National Institute of Mental Health (K02MH001697, MH01697 K02)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Keywords
- cognitive behavioral therapy, mood disorders, depression, bipolar disorder, antidepressants, relapse prevention, treatment moderators, comorbidities, Axis II personality disorders, treatment outcomes
- MeSH terms
- Antidepressive Agents, Combined Modality Therapy, Humans, Cognitive Behavioral Therapy, Treatment Outcome, Mood Disorders, Secondary Prevention
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