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CBT for the treatment of resistant depression

Portfolio politics

Louise Newson

10 December 2012

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LB_Blog_Depression_10_12_2012.jpgIt is now well accepted that patients with mild to moderate depression respond well to cognitive behavioural therapy (CBT) and this is actually one of the recommended treatments. CBT is a form of talking psychotherapy to help people with depression change the way they think to improve how they feel and alter their behaviour. In fact up to two-thirds of people with depression do not actually respond to anti-depressants.

A recent study in the Lancet has demonstrated that CBT can reduce symptoms of depression in people who fail to respond to drug treatment. After six months of receiving CBT, 46% of patients who had received CBT reported at least a 50% reduction in their symptoms. The improvements had been maintained for a period of 12 months, it added. CBT was used in addition to medication for some patients. This is the first randomised controlled study to show that CBT as an adjunct to usual care that includes antidepressants is an effective treatment

Patients with severe and chronic depression were, however, less likely to respond to CBT.

These results add to a wealth of evidence demonstrating the benefits of CBT for managing depression. Depression is very common and its incidence is increasing. However, it is a shame that there still is a huge variation in the types of treatment people with depression receive between different areas in the UK.

In my practice, we seldom refer patients with depression for CBT as the waiting list is in excess of six months. Perhaps the result of this study will help to reduce this wait in the future.

Author

Louise Newson

Louise is a part-time salaried GP in Solihull, West Midlands. She works four sessions a week for a large suburban practice. She also works at the local hospice and has a keen interest in palliative care. She is also interested in evidence-based medicine, predominately in chronic diseases, and teenage health. She writes for numerous other medical publications and also contributes to patient information leaflets on www.patient.co.uk. She is married to a surgeon who is currently working ridiculous hours meaning that childcare (they have 5 and 4 year old girls) and all household duties are completely her responsibility! She finds work/life balance a constant struggle.
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