The response to sulpiride in major depression before and after cognitive behavioural therapy: D2 receptor function

2008 ◽  
Vol 20 (4) ◽  
pp. 199-206 ◽  
Author(s):  
Caroline Bell ◽  
Shamina Bhika ◽  
Richard Porter ◽  
Chris Frampton ◽  
Janet Carter ◽  
...  
Keyword(s):  
Major Depression ◽  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Antidepressant Treatment ◽  
D2 Receptor ◽  
Behavioural Therapy ◽  
Receptor Function ◽  
Cognitive Behavioural ◽  
Increased Sensitivity ◽  
Prolactin Response

Background:Previous studies have suggested that antidepressant treatment of depression may potentiate dopamine transmission through increased sensitivity of postsynaptic D2 receptors.Method:D2 receptor function was assessed in 24 patients with major depression before and 16 patients after 16 weeks of treatment with cognitive behavioural therapy (CBT) using a challenge with a selective D2 antagonist, sulpiride. Four hundred milligrams of sulpiride was administered orally on two test days and response was measured by the change in prolactin levels and changes in self-rating scale measures of mood, anxiety and pleasure.Results:The prolactin response to sulpiride (as measured by the maximum prolactin level) was significantly increased after CBT (z = −2.792, p = 0.005). Sulpiride resulted in an improvement on mood ratings on both test days, but after CBT, this effect was significantly diminished as measured by the Profile of Mood States score (t = −2.27, p = 0.038).Conclusions:After 16 weeks of CBT, we detected an enhanced prolactin response to sulpiride, suggesting an increased sensitivity of D2 receptor functioning.

scholarly journals Effectiveness of cognitive behavioural therapy augmentation in major depression treatment (ECAM study): study protocol for a randomised clinical trial

BMJ Open ◽  
2014 ◽  
Vol 4 (10) ◽  
pp. e006359 ◽  
Author(s):  
Atsuo Nakagawa ◽  
Mitsuhiro Sado ◽  
Dai Mitsuda ◽  
Daisuke Fujisawa ◽  
Toshiaki Kikuchi ◽  
...  
Keyword(s):  
Major Depression ◽  
Cognitive Behavioural Therapy ◽  
Study Protocol ◽  
Rating Scale ◽  
Behavioural Therapy ◽  
Depression Symptoms ◽  
Routine Practice ◽  
Depression Care ◽  
Treatment As Usual ◽  
Cognitive Behavioural

IntroductionMajor depression is a serious mental disorder that causes substantial distress and impairment in individuals and places an enormous burden on society. Although antidepressant treatment is the most common therapy provided in routine practice, there is little evidence to guide second-line therapy for patients who have failed to respond to antidepressants. The aim of this paper is to describe the study protocol for a randomised controlled trial that measures the clinical effectiveness of cognitive behavioural therapy (CBT) as an augmentation strategy to treat patients with non-psychotic major depression identified as suboptimal responders to usual depression care.Methods and analysisThe current study is a 16-week assessor-blinded randomised, parallel-groups superiority trial with 12-month follow-up at an outpatient clinic as part of usual depression care. Patients aged 20–65 years with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) Major Depressive Disorder who have experienced at least one failed trial of antidepressants as part of usual depression care, will be randomly assigned to receive CBT plus treatment as usual, or treatment as usual alone. The primary outcome is the change in clinician-rated 17-item GRID-Hamilton Depression Rating Scale (GRID-HAMD) score at 16 weeks, and secondary outcomes include severity and change in scores of subjective depression symptoms, proportion of responders and remitters, safety and quality of life. The primary population will be the intention-to-treat patients.Ethics and disseminationAll protocols and the informed consent form comply with the Ethics Guideline for Clinical Research (Japanese Ministry of Health, Labour and Welfare). Ethics review committees at the Keio University School of Medicine and the Sakuragaoka Memorial Hospital approved the study protocol. The results of the study will be disseminated at several research conferences and as published articles in peer-reviewed journals. The study will be implemented and reported in line with the CONSORT statement.Trial registration numberUMIN Clinical Trials Registry: UMIN000001218.

Cognitive–Behavioural Therapy via Videoconferencing to a Rural Area

2001 ◽  
Vol 35 (1) ◽  
pp. 62-64 ◽  
Author(s):  
Taryn Cowain
Keyword(s):  
Case Report ◽  
Depressive Symptoms ◽  
Major Depression ◽  
Cognitive Behavioural Therapy ◽  
Married Woman ◽  
Antidepressant Treatment ◽  
South Australia ◽  
Behavioural Therapy ◽  
Rural South ◽  
Cognitive Behavioural

Objective: This case report describes the use of cognitive–behavioural therapy via twoway, interactive audiovisual videoconferencing and identifies issues involved in using this form of technology to provide therapy. Clinical picture: A 38-year-old married woman living in rural South Australia presented with panic disorder with agoraphobia and major depression. The patient had refused antidepressant treatment. Treatment: The patient was treated with 12 sessions of cognitive–behavioural therapy delivered via videoconferencing. Outcome: Anxiety and depressive symptoms resolved with concomitant improvement in function. Conclusions: Providing this form of therapy via videoconferencing can be effective.

scholarly journals Cognitive–behavioural therapy for refractory psychotic symptoms of schizophrenia resistant to atypical antipsychotic medication

2005 ◽  
Vol 186 (4) ◽  
pp. 324-330 ◽  
Author(s):  
Lucia R. Valmaggia ◽  
Mark van der Gaag ◽  
Nicholas Tarrier ◽  
Marieke Pijnenborg ◽  
Cees J. Slooff
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Behavioural Therapy ◽  
Controlled Study ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Cognitive Behavioural ◽  
Supportive Counselling ◽  
Treatment Refractory

BackgroundThere is increasing evidence that cognitive–behavioural therapy can be an effective intervention for patients experiencing drug-refractory positive symptoms of schizophrenia.AimsTo investigate the effects of cognitive–behavioural therapy on in-patients with treatment-refractory psychotic symptoms.MethodManualised therapy was compared with supportive counselling in a randomised controlled study. Both interventions were delivered by experienced psychologists over 16 sessions of treatment. Therapy fidelity was assessed by two independent raters. Participants underwent masked assessment at baseline, after treatment and at 6 months' follow-up. Main outcome measures were the Positive and Negative Syndrome Scale and the Psychotic Symptoms Rating Scale. The analysis was by intention to treat.ResultsParticipants receiving cognitive–behavioural therapy had improved with regard to auditory hallucinations and illness insight at the post-treatment assessment, but these findings were not maintained at follow-up.ConclusionsCognitive–behavioural therapy showed modest short-term benefits over supportive counselling for treatment-refractory positive symptoms of schizophrenia.

Long-term Effects of Cognitive-Behavioural Therapy and Lithium Therapy on Depression in the Elderly

1995 ◽  
Vol 167 (5) ◽  
pp. 653-658 ◽  
Author(s):  
K. C. M. Wilson ◽  
M. Scott ◽  
M. Abou-Saleh ◽  
R. Burns ◽  
J. R. M. Copeland
Keyword(s):  
Maintenance Therapy ◽  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Behavioural Therapy ◽  
Lithium Therapy ◽  
Controlled Study ◽  
Depression Severity ◽  
Cognitive Behavioural

BackgroundWe examine the effects of cognitive-behavioural therapy (CBT) as an adjuvant to acute physical treatment and lithium maintenance therapy in reducing depression severity over a follow-up year in elderly depressed patients.MethodThe study consists of three phases. During the acute treatment and continuation phase, 17 of 31 patients received CBT as an adjuvant to treatment as usual. During the maintenance phase of 1 year, subjects were entered into a double-blind, placebo-controlled study of low-dose lithium therapy.ResultsReceiving adjuvant CBT significantly reduced patients' scores on the Hamilton Rating Scale for Depression during the follow-up year (repeated measures analyses of variance; P = 0.007). No significant differences were found between lithium and placebo maintenance therapy.ConclusionsCBT can be adapted as an adjuvant therapy in the treatment of severely depressed elderly patients and reduces depression severity during follow-up. The prophylactic failure of long-term lithium therapy may be explained through poor compliance.

scholarly journals Cost-effectiveness of selective serotonin reuptake inhibitors and routine specialist care with and without cognitive–behavioural therapy in adolescents with major depression

2007 ◽  
Vol 191 (6) ◽  
pp. 521-527 ◽  
Author(s):  
Sarah Byford ◽  
Barbara Barrett ◽  
Chris Roberts ◽  
Paul Wilkinson ◽  
Bernadka Dubicka ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Major Depression ◽  
Cognitive Behavioural Therapy ◽  
Serotonin Reuptake ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Clinical Care ◽  
Cost Effective ◽  
Behavioural Therapy ◽  
Short Term ◽  
Cognitive Behavioural

BackgroundMajor depression is an important and costly problem among adolescents, yet evidence to support the provision of cost-effective treatments is lacking.AimsTo assess the short-term cost-effectiveness of combined selective serotonin reuptake inhibitors (SSRIs) and cognitive–behavioural therapy (CBT) together with clinical care compared with SSRIs and clinical care alone in adolescents with major depression.MethodPragmatic randomised controlled trial in the UK. Outcomes and costs were assessed at baseline, 12 and 28 weeks.ResultsThe trial comprised 208 adolescents, aged 11–17 years, with major or probable major depression who had not responded to a brief initial psychosocial intervention. There were no significant differences in outcome between the groups with and without CBT. Costs were higher in the group with CBT, although not significantly so (P=0.057). Cost-effectiveness analysis and exploration of the associated uncertainty suggest there is less than a 30% probability that CBT plus SSRIs is more cost-effective than SSRIs alone.ConclusionsA combination of CBT plus SSRIs is not more cost-effective in the short-term than SSRIs alone for treating adolescents with major depression in receipt of routine specialist clinical care.

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