Am J Psychiatry 1994; 151:500-505
Copyright © 1994 by American Psychiatric Association
Do depressed men and women respond similarly to cognitive behavior therapy?
ME Thase, CF Reynolds 3rd, E Frank, AD Simons, J McGeary, AL Fasiczka, GG Garamoni, JR Jennings and DJ Kupfer
Department of Psychiatry, University of Pittsburgh School of Medicine, PA 15213.
OBJECTIVE: A great majority of the evidence pertaining to the effectiveness
of the time-limited psychotherapies as treatments of major depression are
derived from studies of either predominantly or entirely female subject
groups. Depressed men and women differ in a number of important respects
that may alter the course of affective disorder, and as a result, they may
also differ in their responses to psychotherapy. In this study the outcomes
of 40 men and 44 women treated with cognitive behavior therapy were
compared. METHOD: The patients were interviewed with the Schedule for
Affective Disorders and Schizophrenia and diagnosed according to the
Research Diagnostic Criteria and DSM-III-R criteria. Subsequently, they
were assessed every other week (with the Hamilton Depression Rating Scale,
Beck Depression Inventory, and Global Assessment Scale) during a
standardized, time- limited cognitive behavior therapy protocol. The
outcomes of the men and women were compared by means of a series of
analyses of variance and covariance and survival analyses. RESULTS: There
were several significant pretreatment differences, and the men attended
significantly fewer therapy sessions than the women. Although the men and
women generally had comparable responses, patients with higher pretreatment
levels of depressive symptoms, particularly women, had poorer outcomes.
CONCLUSIONS: This study provides further evidence of gender-specific
differences in depressed patients' symptoms and treatment utilization.
Cognitive behavior therapy appears to be a comparably useful outpatient
treatment for men and women. However, either more intensive cognitive
behavior therapy or alternative methods of treatment may be warranted for
patients with more severe syndromes.
