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Acute and one-year outcome of a randomised controlled trial of brief cognitive therapy for major depressive disorder in primary care

Published online by Cambridge University Press:  03 January 2018

Christine Scott*
Affiliation:
North Road Surgery, 77 North Road, Richmond, London
Mary Jane Tacchi
Affiliation:
Newcastle General Hospital, Newcastle upon Tyne
Roger Jones
Affiliation:
Division of Primary Health Care, United Medical and Dental Schools, London
Jan Scott
Affiliation:
University Department of Psychiatry, Royal Victoria Infirmary, Newcastle upon Tyne
*
Dr Christine Scott, North Road Surgery, 77 North Road, Richmond TW9 4HQ

Abstract

Background

The consensus statement on the treatment of depression (Paykel & Priest, 1992) advocates the use of cognitive therapy techniques as an adjunct to medication.

Method

This paper describes a randomised controlled trial of brief cognitive therapy (BCT) plus ‘treatment as usual’ versus treatment as usual in the management of 48 patients with major depressive disorder presenting in primary care.

Results

At the end of the acute phase, significantly more subjects (P < 0.05) met recovery criteria in the intervention group (n=15) compared with the control group (n=8). When initial neuroticism scores were controlled for, reductions in Beck Depression Inventory and Hamilton Rating Scale for Depression scores favoured the BCT group throughout the 12 months of follow-up.

Conclusions

BCT may be beneficial, but given the time constraints, therapists need to be more rather than less skilled in cognitive therapy. This, plus methodological limitations, leads us to advise caution before applying this approach more widely in primary care.

Type
Papers
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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References

REFERENCES

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM–III–R). Washington, DC: APA.Google Scholar
Barkham, M., Moorey, J., Brown, C., et al (1992) Cognitive–behavioural therapy in two-plus-one sessions: a pilot field trial. Behavioural Psychotherapy, 20, 147154.Google Scholar
Beck, A. T., Ward, C. H., Mendelsohn, M., at al (1961) An inventory for measuring depression. Archives of General Psychiatry, 4, 561571.Google Scholar
Blackburn, I. M., Bishop, M., Glen, A. I. M., et al (1981) The efficacy of cognitive therapy in depression: a treatment trial using cognitive therapy and pharmacotherapy, each alone and in combination. British Journal of Psychiatry, 139, 181189.CrossRefGoogle ScholarPubMed
Corney, R. H. (1981) Social work effectiveness in the management of depressed women: a clinical trial. Psychological Medicine, 11, 417423.CrossRefGoogle ScholarPubMed
Eysenck, H. J. & Eysenck, S. B. G. (1964) Manual of the Eysenck Personality Inventory London: University of London Press.Google Scholar
Fennell, M. J. V. & Teasdale, J. D. (1987) Cognitive therapy for depression: individual differences and the process of change. Cognitive Therapy and Research, 11, 253271.CrossRefGoogle Scholar
Frank, E., Prien, R. F., Jarrett, R. B., et al (1991) Conceptualisation and rationale for consensus definitions of terms in major depressive disorder. Archives of General Psychiatry, 48, 851855.CrossRefGoogle ScholarPubMed
Hamilton, M. A. (1960) A rating scale for depression. British Journal of Psychiatry, 23, 5662.Google Scholar
Mynors-Wallis, L. M., Gath, D. H., Lloyd-Thomas, A. R., et al (1995) Randomized controlled trial comparing problem solving treatment with amitriptyline and placebo for depression in primary care. British Medical Journal, 310, 441445.Google Scholar
Paykel, E. S. & Priest, R. G. (1992) Recognition and management of depression in general practice: consensus statement. British Medical Journal, 305, 11981202.CrossRefGoogle ScholarPubMed
Ross, M. & Scott, M. (1985) An evaluation of the effectiveness of individual and group cognitive therapy in the treatment of depressed patients in an inner city health centre. Journal of the Royal College of General Practitioners, 35, 239242.Google Scholar
Scott, A. I. F. & Freeman, C. (1992) Edinburgh primary care depression study: treatment outcome, patient satisfaction, and cost after 16 weeks. British Medical Journal, 304, 883887.CrossRefGoogle Scholar
Scott, C. S., Scott, J., Tacchi, M. J., et al (1994) Abbreviated cognitive therapy for depression: a pilot study in primary care. Behavioural and Cognitive Psychotherapy, 22, 96102.CrossRefGoogle Scholar
Scott, J. (1992) Chronic depression: can cognitive therapy succeed when other treatments fail? Behavioural and Cognitive Psychotherapy, 20, 2534.Google Scholar
Scott, J. (1996) Cognitive therapy of affective disorders: a review. Journal of Affective Disorders, 37, 111.Google Scholar
Sibbald, B., Addington-Hall, J., Breneman, D., et al (1993) Counsellors in English and Welsh general practices: their nature and distribution. British Medical Journal, 306, 2933.Google Scholar
Teasdale, J. D., Fennell, M. J. V., Hibbert, G., et al (1984) Cognitive therapy for major depressive disorder in primary care. British Journal of Psychiatry, 144, 400406.Google Scholar
Young, J. & Beck, A. T. (1980) Manual of the Cognitive Therapy Rating Scale. Penn University: Center for Cognitive Therapy.Google Scholar
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