Skip to main content

Clinical effectiveness of cognitive therapy v. interpersonal psychotherapy for depression: results of a randomized controlled trial

  • L. H. J. M. Lemmens (a1), A. Arntz (a1) (a2), F. Peeters (a3) (a4), S. D. Hollon (a5), A. Roefs (a1) and M. J. H. Huibers (a1) (a6)...

Although both cognitive therapy (CT) and interpersonal psychotherapy (IPT) have been shown to be effective treatments for major depressive disorder (MDD), it is not clear yet whether one therapy outperforms the other with regard to severity and course of the disorder. This study examined the clinical effectiveness of CT v. IPT in a large sample of depressed patients seeking treatment in a Dutch outpatient mental health clinic. We tested whether one of the treatments was superior to the other at post-treatment and at 5 months follow-up. Furthermore, we tested whether active treatment was superior to no treatment. We also assessed whether initial depression severity moderated the effect of time and condition and tested for therapist differences.


Depressed adults (n = 182) were randomized to either CT (n = 76), IPT (n = 75) or a 2-month waiting list control (WLC) condition (n = 31). Main outcome was depression severity, measured with the Beck Depression Inventory – II (BDI-II), assessed at baseline, 2, 3, and 7 months (treatment phase) and monthly up to 5 months follow-up (8–12 months).


No differential effects between CT and IPT were found. Both treatments exceeded response in the WLC condition, and led to considerable improvement in depression severity that was sustained up to 1 year. Baseline depression severity did not moderate the effect of time and condition.


Within our power and time ranges, CT and IPT appeared not to differ in the treatment of depression in the acute phase and beyond.

Corresponding author
* Address for correspondence: L. Lemmens, MSc, Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, Maastricht, The Netherlands. (Email:
Hide All
Ablon, JS, Jones, EE (1999). Psychotherapy process in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology 67, 6475.
Beck, AT, Rush, AJ, Shaw, BF, Emery, G (1979). Cognitive Therapy of Depression. Guilford Press: New York.
Beck, AT, Steer, R, Brown, GK (1996). Beck Depression Inventory II: Manual. Harcourt Brace: Boston.
Beck, JS (1995). Cognitive Therapy: Basics and Beyond. Guilford Press: New York.
Bellino, S, Zizza, M, Rinaldi, C, Bogetto, F (2007). Combined therapy of major depression with concomitant borderline personality disorder: comparison of interpersonal and cognitive psychotherapy. Canadian Journal of Psychiatry/La Revue canadienne de psychiatrie 52, 718725.
Cohen, J (1988). Statistical Power Analysis for the Behavioral Sciences. Erlbaum: Hillsdale, NJ.
Crits-Christoph, P, Baranackie, K, Kurcias, J, Beck, A, Carroll, K, Perry, K, Luborsky, L, McLellan, A, Woody, G, Thompson, L, Gallagher, D, Zitrin, C (1991). Meta-analysis of therapist effects in psychotherapy outcome studies. Psychotherapy Research 1, 8191.
Cuijpers, P, Li, J, Hofmann, SG, Andersson, G (2010). Self-reported versus clinician-rated symptoms of depression as outcome measures in psychotherapy research on depression: a meta-analysis. Clinical Psychology Review 30, 768778.
Cuijpers, P, van Straten, A, Andersson, G, van Oppen, P (2008). Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology 76, 909922.
Derogatis, LR, Melisaratos, N (1983). The Brief Symptom Inventory: an introductory report. Psychological Medicine 13, 595605.
Dimidjian, S, Hollon, SD, Dobson, KS, Schmaling, KB, Kohlenberg, RJ, Addis, ME, Gallop, R, McGlinchey, JB, Markley, DK, Gollan, JK, Atkins, DC, Dunner, DL, Jacobson, NS (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology 74, 658670.
Dobson, KS, Shaw, BF, Vallis, TM (1985). Reliability of a measure of the quality of cognitive therapy. British Journal of Clinical Psychology 24, 295300.
Dolan, P (1997). Modeling valuations for EuroQol health states. Medical Care 35, 10951108.
Driessen, E, Cuijpers, P, Hollon, SD, Dekker, JJM (2010). Does pretreatment severity moderate the efficacy of psychological treatment of adult outpatient depression? A meta-analysis. Journal of Consulting and Clinical Psychology 78, 668680.
Drummond, MF, Schulpher, MJ, Torrance, GW, O'Brien, B, Stoddart, GL (2005). Methods for the Economic Evaluation of Health Care Programmes, 3rd edn. Oxford University Press: Oxford.
Elkin, I, Shea, MT, Watkins, JT, Imber, SD (1989). National Institute of Mental Health Treatment of Depression Collaborative Research Program: general effectiveness of treatments. Archives of General Psychiatry 46, 971982.
EuroQolGroup (1990). EuroQol – a new facility for the measurement of health-related quality of life. Health Policy 16, 199208.
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1997). Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Biometrics Research Department New York State Psychiatric Institute: New York.
Fournier, JC, DeRubeis, RJ, Hollon, SD, Dimidjian, S, Amsterdam, JD, Shelton, MC, Fawcett, J (2010). Antidepressant drug effects and depression severity: a patient-level meta-analysis. Journal of the American Medical Association 303, 4753.
Hardy, GE, Barkham, M, Shapiro, DA, Stiles, WB, Rees, A, Reynolds, S (1995). Impact of Cluster C personality disorders on outcomes of contrasting brief psychotherapies for depression. Journal of Consulting and Clinical Psychology 63, 9971004.
Hill, CE, O'Grady, KE, Elkin, I (1992). Applying the Collaborative Study Psychotherapy Rating Scale to rate therapist adherence in cognitive-behavior therapy, interpersonal therapy, and clinical management. Journal of Consulting and Clinical Psychology 60, 7379.
Hollon, SD, Evans, MD, Auerbach, A, DeRubeis, RJ, Elkin, I, Lowery, A, Kriss, M, Grove, W, Tuason, VB, Piasecki, J (1988). Development of a system for rating therapies for depression: differentiating cognitive therapy, interpersonal psychotherapy, and clinical management pharmacotherapy (unpublished manuscript).
Hollon, SD, Waskow, IE, Evans, M, Lowery, HA (1984). Systems for Rating Therapies for Depression. Annual Convention of the American Psychiatric Association: Los Angeles, CA.
Jacobson, NS, Truax, P (1991). Clinical significance: a statistical approach to define meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 59, 1219.
Jakobsen, JC, Hansen, JL, Simonsen, S, Simonsen, E, Gluud, C (2012). Effects of cognitive therapy versus interpersonal psychotherapy in patients with major depressive disorder: a systematic review of randomized clinical trials with meta-analyses and trial sequential analyses. Psychological Medicine 42, 13431357.
Jarrett, RB, Schaffer, M, McIntire, D, Witt-Browder, A, Kraft, D, Risser, RC (1999). Treatment of atypical depression with cognitive therapy or phenelzine: a double-blind, placebo-controlled trial. Archives of General Psychiatry 56, 431437.
Kazdin, AE (2009). Understanding how and why psychotherapy leads to change. Psychotherapy Research 19, 418428.
Keitner, GI, Ryan, CE, Solomon, DA (2006). Realistic expectations and a disease management model for depressed patients with persistent symptoms. Journal of Clinical Psychiatry 67, 14121421.
Kennedy, SH, Eisfeld, BS, Cooke, RG (2001). Quality of life: an important dimension in assessing the treatment of depression? Journal of Psychiatry and Neuroscience 26, 2328.
Klein, DF (1990). NIMH collaborative research on treatment of depression. Archives of General Psychiatry 47, 682684.
Klerman, GL, Weissman, MM, Rounsaville, BJ, Chevron, ES (1984). Interpersonal Psychotherapy for Depression. Basis Books: New York.
Lamers, LM, McDonnell, J, Stalmeier, PFM, Krabbe, PFM, Busschbach, JJV (2006). The Dutch tariff: results and arguments for an effective design for national EQ-5D valuation studies. Health Economics 15, 11211132.
Lemmens, LHJM, Arntz, A, Peeters, FPML, Hollon, SD, Roefs, A, Huibers, MJH (2011). Effectiveness, relapse prevention and mechanisms of change of cognitive therapy vs. interpersonal therapy for depression: study protocol for a randomised controlled trial. Trials 12, 150162.
Luty, SE, Carter, JD, McKenzie, JM, Rae, AM, Frampton, CMA, Mulder, RT, Joyce, PR (2007). Randomised controlled trial of interpersonal psychotherapy and cognitive-behavioural therapy for depression. British Journal of Psychiatry 190, 496502.
Markowitz, JC, Weissman, MM (2004). Interpersonal psychotherapy: principles and applications. World Psychiatry 3, 136139.
Moher, D, Hopewell, S, Schulz, KF, Montori, V, Gotzsche, PC, Deveraux, PJ, Elbourne, D, Egger, M, Altman, DG (2010). Research methods & reporting: CONSORT 2010 explanation and elaboration: updated guidelines for reporting parallel group randomised trials. British Medical Journal (Clinical Research Edition) 340, c869.
Mundt, JC, Marks, IM, Greist, JH, Shear, K (2002). The Work and Social Adjustment Scale: a simple accurate measure of impairment in functioning. British Journal of Psychiatry 180, 461464.
Quilty, LC, McBride, C, Bagby, RM (2008). Evidence for the cognitive mediational model of cognitive behavioural therapy for depression. Psychological Medicine 38, 15311541.
Spijker, J, Bockting, CLH, Meeuwissen, JAC, van Vliet, IM, Emmelkamp, PMG, Hermens, MLM, van Balkom, ALJM (2013). Multidisciplinary guideline for depression (third revision): guideline for assessment, treatment and counselling of adults with mood disorders. Trimbos-instituut: Utrecht.
Stuart, S (2011). IPT Adherence and Quality Scale. Interpersonal Psychotherapy Institute: Iowa (unpublished manuscript).
Wallace, BC, Daharbreh, IJ, Trikalinos, TA, Lau, J, Trow, P, Schmid, CH (2012). Closing the gap between methodologists and end-users: R as a computational back-end. Journal of Statistical Software 49, 115.
Weissman, MM, Markowitz, JC, Klerman, GL (2000). Comprehensive Guide to Interpersonal Psychotherapy. Basic Books: New York.
Willemse, Y, Trijsburg, RW (2005). Cognitive Behavioural Therapy and Interpersonal Psychotherapy: and analysis of critical success factors. Tijdschrift voor Psychiatrie 47, 593602.
Zee van der, KI, Sanderman, R (1993). Assessing the general health condition using the RAND-36: a manual. Northern Center for health questions: Groningen.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
Please enter your name
Please enter a valid email address
Who would you like to send this to? *


Type Description Title
Supplementary materials

Lemmens supplementary material
Lemmens supplementary material 1

 Word (64 KB)
64 KB


Altmetric attention score

Full text views

Total number of HTML views: 121
Total number of PDF views: 677 *
Loading metrics...

Abstract views

Total abstract views: 1955 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 15th August 2018. This data will be updated every 24 hours.