Does A Placebo Tablet Affect Psychotherapeutic Treatment Outcome? Results from the Pittsburgh Study of Maintenance Therapies in Recurrent Depression

Since combinations of medication and psychotherapy are being increasingly used in randomized clinical trials, an important issue is whether psychotherapy administered with a double-blind placebo tablet is different from psychotherapy unaccompanied by pill-taking. This study reports no significant differences in these two treatment conditions for patients with recurrent depression entered into a long-term maintenance trial with respect to either treatment outcome (e.g., recurrence, restabilization, attrition), psychobiological parameters (e.g., sleep physiology in recovery), or treatment specificity ratings. Our findings suggest that either a psychotherapy with placebo tablet condition or a more ecologically valid psychotherapy without placebo tablet may be suitable in long-term maintenance treatment trials of recurrent depression. Whether these results can be generalized to acute treatment trials or to long-term studies of other disorders remains an open question.