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The British Journal of Psychiatry (2000) 177: 440-446
© 2000 The Royal College of Psychiatrists

Effects of cognitive therapy on psychological symptoms and social functioning in residual depression

JAN SCOTT, FRCPsych

Gartnavel Royal Hospital, Glasgow

JOHN D. TEASDALE, PhD

MRC Cognition and Brain Science Unit, Cambridge

EUGENE S. PAYKEL, FRCPsych

University of Cambridge, Cambridge

ANTHONY L. JOHNSON, CStat

MRC Biostatistics Unit, University of Cambridge Institute of Public Health

ROSEMARY ABBOTT, PhD, HAZEL HAYHURST, PhD and RICHARD MOORE, PhD

University of Cambridge, Cambridge

ANNE GARLAND, BA

University of Manchester, Manchester

Correspondence: Professor Jan Scott, Department of Psychological Medicine, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH; tel: 01412113937; fax: 0141357 4899; e-mail: jan.scott{at}clinmed.gla.ac.uk

Declaration of interest Supported by grants from the Medical Research Council and an additional grant from the Oxford and Anglia Region.

Background About 30% of psychiatric out-patients with major depression demonstrate partial remission.

Aims To explore whether the addition of cognitive therapy (CT) had any differential effect on residual symptoms or social adjustment.

Method Patients with residual symptoms of major depression (n=158) were randomised to receive clinical management (CM) alone, or CM plus 18 sessions of CT. Subjects' depressive symptoms and social functioning were assessed regularly over 16 months.

Results The addition of CT produced statistically significant differential effects on: two out of four measures of overall severity of depression; specific psychological symptoms (guilt, self-esteem and hopelessness); and social functioning (including dependency, interpersonal behaviour and friction).

Conclusions In patients showing only partial response to antidepressants, the addition of CT produced modest improvements in social and psychological functioning. The implications for research on the mechanisms of action of CT are discussed.




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