A Randomized Controlled Trial of Cognitive Behavioural Therapy as an Adjunct to Pharmacotherapy in Primary Care Based Patients with Treatment Resistant Depression: A Pilot Study
No randomized controlled trials (RCTs) have been conducted of cognitive behavioural therapy (CBT) for depressed patients who have not responded to antidepressants, yet CBT is often reserved for this group. We conducted a pilot study for a pragmatic RCT of the clinical effectiveness of CBT as an adju...
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| Veröffentlicht in: | Behavioural and cognitive psychotherapy 2008-01, Vol.36 (1), p.21-33 |
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| creator | Wiles, Nicola J Hollinghurst, Sandra Mason, Victoria Musa, Meyrem Burt, Victoria Hyde, Julia Jerrom, Bill Lewis, Glyn Kessler, David |
| description | No randomized controlled trials (RCTs) have been conducted of cognitive behavioural therapy (CBT) for depressed patients who have not responded to antidepressants, yet CBT is often reserved for this group. We conducted a pilot study for a pragmatic RCT of the clinical effectiveness of CBT as an adjunct to pharmacotherapy in primary care based patients with treatment resistant depression (TRD). Patients on antidepressants for at least 6 weeks were mailed a study invitation by their GP. Those who consented to contact were mailed a questionnaire. TRD was defined as compliance with medication (self-report) and Beck Depression Inventory (BDI) ≥ 15. Those who met ICD-10 depression criteria were eligible for randomization and followed after 4 months. Of 440 patients mailed, 65% responded and 72% consented to contact. Ninety-four percent completed the questionnaire and 82 patients (42%) had TRD. Thirty were subsequently identified as ineligible and 10 did not participate further. Twenty-six of the remaining 42 patients met ICD-10 depression criteria and 25 agreed to being randomized. Twenty-three patients completed the 4-month follow-up questionnaire. Recruitment into a RCT to examine the effectiveness of CBT as an adjunct to pharmacotherapy in primary care based patients with TRD appears feasible and should now be conducted. |
| doi_str_mv | 10.1017/S135246580700389X |
| format | Article |
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We conducted a pilot study for a pragmatic RCT of the clinical effectiveness of CBT as an adjunct to pharmacotherapy in primary care based patients with treatment resistant depression (TRD). Patients on antidepressants for at least 6 weeks were mailed a study invitation by their GP. Those who consented to contact were mailed a questionnaire. TRD was defined as compliance with medication (self-report) and Beck Depression Inventory (BDI) ≥ 15. Those who met ICD-10 depression criteria were eligible for randomization and followed after 4 months. Of 440 patients mailed, 65% responded and 72% consented to contact. Ninety-four percent completed the questionnaire and 82 patients (42%) had TRD. Thirty were subsequently identified as ineligible and 10 did not participate further. Twenty-six of the remaining 42 patients met ICD-10 depression criteria and 25 agreed to being randomized. Twenty-three patients completed the 4-month follow-up questionnaire. Recruitment into a RCT to examine the effectiveness of CBT as an adjunct to pharmacotherapy in primary care based patients with TRD appears feasible and should now be conducted.</description><identifier>ISSN: 1352-4658</identifier><identifier>EISSN: 1469-1833</identifier><identifier>DOI: 10.1017/S135246580700389X</identifier><language>eng</language><publisher>Cambridge, UK: Cambridge University Press</publisher><subject>Adult and adolescent clinical studies ; Antidepressants ; Behavior therapy. Cognitive therapy ; Biological and medical sciences ; Clinical trials ; Compliance ; Data collection ; Depression ; Early intervention ; Electronic monitoring ; Health services ; Medical sciences ; Mental depression ; Mood disorders ; Neuropharmacology ; Patients ; Personality disorders ; Pharmacology. 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We conducted a pilot study for a pragmatic RCT of the clinical effectiveness of CBT as an adjunct to pharmacotherapy in primary care based patients with treatment resistant depression (TRD). Patients on antidepressants for at least 6 weeks were mailed a study invitation by their GP. Those who consented to contact were mailed a questionnaire. TRD was defined as compliance with medication (self-report) and Beck Depression Inventory (BDI) ≥ 15. Those who met ICD-10 depression criteria were eligible for randomization and followed after 4 months. Of 440 patients mailed, 65% responded and 72% consented to contact. Ninety-four percent completed the questionnaire and 82 patients (42%) had TRD. Thirty were subsequently identified as ineligible and 10 did not participate further. Twenty-six of the remaining 42 patients met ICD-10 depression criteria and 25 agreed to being randomized. Twenty-three patients completed the 4-month follow-up questionnaire. Recruitment into a RCT to examine the effectiveness of CBT as an adjunct to pharmacotherapy in primary care based patients with TRD appears feasible and should now be conducted.</abstract><cop>Cambridge, UK</cop><pub>Cambridge University Press</pub><doi>10.1017/S135246580700389X</doi><tpages>13</tpages></addata></record> |
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| subjects | Adult and adolescent clinical studies Antidepressants Behavior therapy. Cognitive therapy Biological and medical sciences Clinical trials Compliance Data collection Depression Early intervention Electronic monitoring Health services Medical sciences Mental depression Mood disorders Neuropharmacology Patients Personality disorders Pharmacology. Drug treatments Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease) Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Psychopharmacology Recruitment Treatments |
| title | A Randomized Controlled Trial of Cognitive Behavioural Therapy as an Adjunct to Pharmacotherapy in Primary Care Based Patients with Treatment Resistant Depression: A Pilot Study |
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