Is there an Alternative to Drugs in the Treatment of Depressed Ambulatory Patients?

Sixty-four patients suffering from primary major depressive illness from hospital and general practice clinics were randomly allocated to three treatment groups: drug of choice, cognitive therapy and a combination of the two. Looking at end-point scores on two rating scales of depression, there was no difference in the proportion of responders to the three treatments in the hospital group, but in the general practice, significantly less patients treated with drugs improved. Looking at group mean changes from baseline, all groups improved significantly on most variables except for the general practice drug group. The potential value of cognitive therapy for therapy-resistant hospital patients and for general practice patients is discussed.