Cognitive behavioural therapy has short term but not long term benefits in people with residual symptoms of depression

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.

Download Full-text

Cognitive–behavioural therapy for personal recovery of patients with schizophrenia: A systematic review and meta-analysis

General Psychiatry ◽

10.1136/gpsych-2018-100040 ◽

2019 ◽

Vol 32 (4) ◽

pp. e100040

Author(s):

Weiliang Wang ◽

Yuqiu Zhou ◽

Nannan Chai ◽

Dongwei Liu

Keyword(s):

Cognitive Behavioural Therapy ◽

Effect Size ◽

Behavioural Therapy ◽

Post Treatment ◽

Effect Sizes ◽

Fundamental Aspect ◽

Long Term Effects ◽

Personal Recovery ◽

Cognitive Behavioural

BackgroundTo date, cognitive–behavioural therapy (CBT) trials have primarily focused on clinical recovery; however, personal recovery is actually the fundamental aspect of the recovery process. The aim of this study was to summarise and synthesise the existing evidence regarding the effectiveness of CBT for personal recovery in patients with schizophrenia.AimThis study aimed to determine the effectiveness of CBT for personal recovery in patients with schizophrenia.MethodsA systematic search of the literature in PsycINFO, PubMed, Cochrane (CENTRAL), Embase and Web of Science (SCI) was conducted to identify randomised controlled trials reporting the impact of CBT interventions on personal recovery in patients with schizophrenia. The estimated effect sizes of the main study outcomes were calculated to estimate the magnitude of the treatment effects of CBT on personal recovery. We also evaluated the CBT’s effect size at the end-of-treatment and long-term (follow-up) changes in some aspects of personal recovery.ResultsTwenty-five studies were included in the analysis. The effect of CBT on personal recovery was 2.27 (95% CI 0.10 to 4.45; I2=0%; p=0.04) at post-treatment and the long-term effect size was 2.62 (95% CI 0.51 to 4.47; I2=0%; p=0.02). During the post-treatment period, the pooled effect size of CBT was 0.01 (95% CI −0.12 to 0.15; I2=33.0%; p>0.05) for quality of life (QoL), 0.643 (95% CI 0.056 to 1.130; I2=30.8%; p<0.01) for psychological health-related QoL, −1.77 (95% CI −3.29 to −0.25; I2=40%; p=0.02) for hopelessness and 1.85 (95% CI 0.69 to 3.01; I2=41%; p<0.01) for self-esteem. We also summarised the effects of CBT on QoL (subscale scores not included in the evaluation of the pooled effect size), self-confidence and connectedness, and all results corresponded to positive effects. However, there was insufficient evidence regarding the long-term effects of CBT on personal recovery.ConclusionsCBT is an effective therapy with meaningful clinical effect sizes on personal recovery and some aspects of personal recovery of schizophrenia after treatment. However, the effect is relatively immediate and rapidly decreases as time progresses. Therefore, in the future, more studies should focus on the mechanism of CBT for personal recovery and the factors that influence the long-term effects of CBT.Trial registration numberCRD42018085643.

Download Full-text

Long‐term benefits of digital cognitive behavioural therapy for insomnia: Follow‐up report from a randomized clinical trial

Journal of Sleep Research ◽

10.1111/jsr.13018 ◽

2020 ◽

Vol 29 (4) ◽

Cited By ~ 1

Author(s):

Annemarie I. Luik ◽

Antonia Marsden ◽

Richard Emsley ◽

Alasdair L. Henry ◽

Richard Stott ◽

...

Keyword(s):

Clinical Trial ◽

Randomized Clinical Trial ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Cognitive Behavioural

Download Full-text

Benefits of non-drug interventions for people with suicidal crises in unipolar depression

European Journal of Public Health ◽

10.1093/eurpub/ckz186.591 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

E Berger ◽

S Fuchs ◽

N Baier ◽

H Peters ◽

R Busse

Keyword(s):

Health Care ◽

Suicide Attempt ◽

Drug Treatment ◽

Cognitive Behavioural Therapy ◽

Unipolar Depression ◽

Behavioural Therapy ◽

Short Term ◽

Effective Interventions ◽

Cognitive Behavioural ◽

Drug Interventions

Abstract Background Depression is one of the most common and serious diseases worldwide: According to WHO, more than 300 million people worldwide were affected by depression in 2015. In this group, the suicide rate is about 20 times higher than the population average. In Germany, around 10,000 people take their lives each year, many of them suffering from depression. The Institute for Quality and Efficiency in Health Care commissioned the Department of Health Care Management at the Berlin University of Technology to conduct a Health Technology Assessment on whether non-drug interventions influence coping with suicidal crises in unipolar depression. Methods A systematic search of primary studies and systematic reviews (e.g., in MEDLINE, PSYCINFO) was performed to assess the benefit of ambulatory crisis intervention programmes or psychosocial interventions compared to another non-drug treatment, drug treatment, inpatient treatment or no treatment/waiting list in adult suicidal patients with unipolar depression regarding patient-relevant outcomes (e.g., suicide attempts, suicidal ideation, depression). Results The search yielded a total of 4,159 hits. After two rounds of screening for relevance and removing duplicates, 4 studies remained for inclusion in the qualitative and quantitative analysis. The studies present RCTs assessing the effects of cognitive behavioural therapy (CBT) of the 2. and 3. wave - all short-term programmes focussing on suicidality. Results indicate a benefit of CBT compared to standard treatment, depending on the outcome, on the “wave” and on the time of follow up assessment. Conclusions There is some evidence on benefits of CBT for adult patients with suicidal crises in unipolar depression. However, the quality of the included RCTs is weak and evidence on benefits of other non-drug interventions in outpatient care is missing. Further research is needed to identify effective interventions, especially for the vulnerable weeks immediately after suicide attempt. Key messages Short term cognitive behavioural therapy with suicidal prevention elements may influence coping with suicidal crises in unipolar depression positively. Further research is needed to identify effective interventions for the vulnerable weeks immediately after suicide attempt.

Download Full-text

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

The British Journal of Psychiatry ◽

10.1192/bjp.bp.107.038984 ◽

2007 ◽

Vol 191 (6) ◽

pp. 521-527 ◽

Cited By ~ 53

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.

Download Full-text

Treatment of Mixed Anxiety-Depression Disorder: Long-Term Outcome

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465805002511 ◽

2005 ◽

Vol 34 (1) ◽

pp. 95-101 ◽

Cited By ~ 4

Author(s):

Enrique Echeburúa ◽

Karmele Salaberría ◽

Paz de Corral ◽

Raúl Cenea ◽

Tomás Berasategui

Keyword(s):

Drug Therapy ◽

Cognitive Behavioural Therapy ◽

Behavioural Therapy ◽

Control Group ◽

Standard Drug ◽

Cognitive Behavioural ◽

Anxiety Depression ◽

Depression Disorder

The aim of this paper was to test the long-term contribution of cognitive-behavioural therapy to the treatment of mixed anxiety-depression disorder. Fifty-seven patients, selected according to DSM-IV diagnostic criteria, were assigned to: 1) cognitive-behavioural therapy; 2) combined therapy (drug and cognitive-behavioural therapy); or 3) a standard drug therapy control group. A multigroup experimental design with repeated measures of assessment (pretreatment, posttreatment, and 3-, 6- and 12 month follow-ups) was used. Most patients who were treated (71%) in experimental groups showed significant improvement at the 12-month follow-up, but there were no differences between the two therapeutic modes. No improvement was shown by the control-group participants at the 6-month follow-up. The results of the present trial do not support the beneficial effects of drug therapy by itself for this disorder. Finally, several topics that may contribute to future research in this field are discussed.

Download Full-text

Cognitive behavioural therapy combined with the relapse-prevention medication acamprosate: are short-term treatment outcomes for alcohol dependence improved?

Australian & New Zealand Journal of Psychiatry ◽

10.1046/j.1440-1614.2002.01019.x ◽

2002 ◽

Vol 36 (5) ◽

pp. 622-628 ◽

Cited By ~ 27

Author(s):

Gerald F.X. Feeney ◽

Ross Mc.D. Young ◽

Jason P. Connor ◽

Jane Tucker ◽

Annie McPherson

Keyword(s):

Alcohol Dependence ◽

Treatment Outcomes ◽

Cognitive Behavioural Therapy ◽

Relapse Prevention ◽

Behavioural Therapy ◽

Term Treatment ◽

Short Term ◽

Short Term Treatment ◽

Cognitive Behavioural

Download Full-text

Long-term effects on income and sickness benefits after work-focused cognitive-behavioural therapy and individual job support: a pragmatic, multicentre, randomised controlled trial

Occupational and Environmental Medicine ◽

10.1136/oemed-2018-105137 ◽

2018 ◽

Vol 75 (10) ◽

pp. 703-708 ◽

Cited By ~ 8

Author(s):

Simon Øverland ◽

Astrid Louise Grasdal ◽

Silje Endresen Reme

Keyword(s):

Randomised Controlled Trial ◽

Usual Care ◽

Cognitive Behavioural Therapy ◽

Controlled Trial ◽

Intervention Group ◽

Behavioural Therapy ◽

Work Participation ◽

Cognitive Behavioural ◽

Randomised Controlled

BackgroundThere is moderate quality evidence that integrating work-directed interventions and components from psychological therapies reduces sickness absence in the medium term. We aimed to extend this evidence by examining objectively ascertained income and work participation status up to 4 years after an intervention to improve outcomes among people who struggle with work from common mental disorder.MethodsThe intervention combined components from cognitive behavioural therapy with principles from supported employment, and compared its efficacy with usual care. Outcomes were derived from registry data with no attrition, in a pragmatic multisite randomised controlled trial (N=1193).ResultsThe intervention group had higher income, higher work participation and more months without receiving benefits over the 10-month to 46-month long-term follow-up period after end of treatment, but differences were not statistically significant. For the group on long-term benefits at inclusion, effect sizes were larger and statistically significant.ConclusionThere were no statistically significant differences between the two groups in the primary outcome in the total population. In a secondary analysis for the subgroup most at risk of permanent work exclusion, long-term outcomes were favourable in the intervention group compared with usual care. The results support integrated work and health services for people on the severe end of work participation challenges.Trial registration numberNCT01146730.

Download Full-text