Background: The authors examined the patterns of improvement in cognitive and vegetative symptoms of major depression in individuals treated with cognitive therapy (CT) or pharmacotherapy (PT). Method: Outpatients diagnosed with major depressive disorder (n = 180) were randomized to receive either CT or PT. Cognitive and vegetative symptoms of major depression were measured by the Beck Depression Inventory-II at baseline and regularly throughout 16 weeks of treatment. Results: Multivariate hierarchical linear modeling demonstrated the same patterns of change over time for cognitive and vegetative symptoms within CT and within PT. Limitations: Self-report measures may not be sufficiently specific to capture subtle differences in improvements between vegetative and cognitive symptoms. Conclusions: These results are consistent with Beck's [Beck, A.T., 1984, November. Cognition and theory [Letter to the editor]. Arch. Gen. Psychiatry 41, 1112-1114.] hypothesis that CT and PT have a similar site of action, which when targeted, results in changes in both cognitive and vegetative features. © 2007 Elsevier B.V. All rights reserved.