NCPA - National Center for Policy Analysis


May 11, 2005

Ever since biochemists learned to treat mental diseases with drugs, psychotherapy (or talk therapy) has fallen out of favor in the psychiatric field. However, a new study published in the Archives of General Psychiatry finds that talk therapy works just as well as chemical therapy, and is superior after accounting for the lower relapse rate.

The researchers conducted the largest clinical trial ever designed to compare talk therapy with chemical antidepressants. They used 240 patients with moderate to severe depression. The researchers treated some with talk therapy, some with Paxil, and some with placebos. They found:

  • After 16 weeks of treatment, cognitive therapy and drugs had equal results -- 58 percent had some perceptible improvement.
  • However, a year after the treatments ended, 76 percent of those who had been on antidepressants, and then been taken off them, had relapsed, while only 31 percent of the talk therapy group relapsed.
  • Even patients who stayed on antidepressants for the intervening year did not do any better than those who had taken cognitive therapy and then quit.

The findings have profound implications for medical insurance companies. Many companies refuse to pay for expensive psychotherapists, opting to pay for cheaper anti-depressant drugs. But if talk therapy's results last for extended periods, than it would be cheaper in the long run to hire psychotherapists instead of indefinitely refilling prescriptions, say the researchers.

Source: Robert J. DeRubeis and others, "Prevention of Relapse Following Cognitive Therapy vs. Medications in Moderate to Severe Depression," Archive of General Psychiatry, April 2005; and "Talk is cheap," Economist, April 14, 2005.

For study abstract:

For Economist text:


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