# CBT



## poet (Nov 17, 2003)

study shows CBT produces different brain changes than paxil:Study Shows Distinct Effects of CBTby Professional Development and Communications StaffJanuary 29, 2004 -- A Wall Street Journal article ("New Hope for Battling Depression Relapses," 1/4/04) raised the public profile of a recent study examining brain changes associated with the use of cognitive behavioral therapy (CBT) versus antidepressant medication. In the study, Canadian researchers found that the use of CBT causes changes in brain activity that are distinct from changes resulting from the use of paroxetine (Paxil).Study participants had unipolar depression, were not medicated, and received 15 to 20 individual outpatient sessions of CBT. Imaging studies revealed significant metabolic changes in various regions of the brain associated with CBT treatment. The researchers highlighted among their published results that the 14 individuals (of 17 initial participants) who completed the study experienced significant clinical improvement.A post hoc comparison was made to an independent group of 13 individuals treated with paroxetine who also had demonstrated clinical improvement. When the researchers contrasted CBT response changes to paroxetine response changes, they found significant differences between the two treatments in their effect on several portions of the brain, including the cortical and limbic regions. The research was published in the Archives of General Psychiatry (Vol. 61, January, 2004).According to the Wall Street Journal article, the study is the first to demonstrate that a brain responds differently to the two forms of treatment for depression. In commenting that the study findings make sense, psychologist Steven Hollon, PhD, was quoted in the article as saying, "Antidepressants damp down activity in the lower limbic regions, where stress and negative emotions come from. Cognitive-behavior therapy teaches the brain to respond to those signals in a healthier way, and that has a more enduring effect."What Psychology Data SuggestActual clinical practice experience suggests that depression treatment typically involves a combination of psychotherapy and medication, rather than a choice between the two treatment options. Among the highlights of a July 2003 survey of practicing psychologists (241 respondents) about clinical practice patterns:28 percent of participating psychologists' clients had a principal diagnosis of major depressive disorder. An additional 10 percent had a principal diagnosis of dysthymia.86 percent of all pscyhologists' clients with major depression were taking antidepressant medications. Ninety five (95) percent of those treated with CBT were taking medications.For the clients diagnosed with major depression, 43 percent were receiving CBT, while 45 percent were being treated with a combination of psychotherapeutic interventions -- likely including cognitive-behavioral strategies.The survey was conducted by PracticeNet, an Internet-based data collection system whereby the APA Practice Directorate surveys licensed psychologists about what transpires during the delivery of professional services. tom


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