Cognitive therapy of affective disorders: a review

Cognitive therapy is the most extensively researched psychological treatment for nonpsychotic, unipolar outpatient depressive disorders. Careful analysis of published outcome studies suggests that its benefits in acute depression whilst very promising have not been proven, mainly because of inadequate methodology in treatment trials. However, cognitive therapy does appear to reduce the risk of depressive relapse and may have a more durable effect than pharmacotherapy alone. This paper explores short- and long-term outcome data and reviews clinical factors, including therapists competency, that may predict outcome. The development of cognitive approaches to individuals with bipolar disorders is examined. Future areas of research, particularly the need to detect which individuals may differentially respond to cognitive therapy, are identified.