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Thursday, March 18, 2010

Group CBT Is Effective in Treatment-Resistant Depression

I am not a huge fan of cognitive behavioral therapy (CBT), and generally see it as a band-aid that stops the immediate bleeding, but does not treat the wound. However, it is just about the only treatment model being researched these days as a result of the HMO-fueled demand for short-term treatment models. As a result, a lot of people who cannot afford long-term therapy are being treated with CBT. So I guess the goal, then, would be to make CBT as effective as possible - and progress is being made in that area, as this study shows.

To be clear, the group CBT intervention was used in conjunction with medication.

This is an Open Access article from BMC Psychiatry, so if you would like to read it, the link at the bottom will open the pre-publication PDF.

Psychosocial functioning in patients with treatment-resistant depression after group cognitive behavioral therapy

Miki Matsunaga, Yasumasa Okamoto, Shin-ichi Suzuki, Akiko Kinoshita, Shinpei Yoshimura, Atsuo Yoshino,Yoshihiko Kunisato and Shigeto Yamawaki

BMC Psychiatry 2010, 10:22doi:10.1186/1471-244X-10-22


Published:16 March 2010
Abstract (provisional)

Background

Although patients with Treatment Resistant Depression (TRD) often have impaired social functioning, few studies have investigated the effectiveness of psychosocial treatment for these patients. We examined whether adding group cognitive behavioral therapy (group-CBT) to medication would improve both the depressive symptoms and the social functioning of patient with mild TRD, and whether any improvements would be maintained over one year.

Methods

Forty-three patients with TRD were treated with 12 weekly sessions of group-CBT. Patients were assessed with the Global Assessment of Functioning scale (GAF), the 36-item Short-Form Health Survey (SF-36), the Hamilton Rating Scale for Depression (HRSD), the Dysfunctional Attitudes Scale (DAS), and the Automatic Thought Questionnaire-Revised (ATQ-R) at baseline, at the termination of treatment, and at the 12-month follow-up.

Results

Thirty-eight patients completed treatment; five dropped out. For the patients who completed treatment, post-treatment scores on the GAF and SF-36 were significantly higher than baseline scores. Scores on the HRSD, DAS, and ATQ-R were significantly lower after the treatment. Thus patients improved on all measurements of psychosocial functioning and mood symptoms. Twenty patients participated in the 12-month follow-up. Their improvements for psychosocial functioning, depressive symptoms, and dysfunctional cognitions were sustained at 12 months following the completion of group-CBT.

Conclusions

These findings suggest a positive effect that the addition of cognitive behavioural group therapy to medication on depressive symptoms and social functioning of mildly depressed patients, showing treatment resistance.

The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.



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