Can cognitive behavioural therapy help defeat depression?

Jan 22 2009

The effectiveness of cognitive behavioural therapy (CBT) for the treatment of depression will be examined by researchers at the University of Bristol as part of the National Institute for Health Research Health Technology Assessment (NIHR HTA) programme.

CBT, a combination of psychotherapy and behavioural therapy, works by changing people's attitudes and behaviour by focusing on their thoughts, images, beliefs and attitudes and how these relates to the way they behave.  Existing research suggests that CBT may be effective in tackling depression, but more evidence is needed.

In a £1.2 million clinical trial researchers, led by Dr Nicola Wiles at the University of Bristol, are investigating CBT for patients with depression who do not respond to treatment with antidepressants.  Patients who have been taking antidepressants for at least six weeks will be invited to participate in the trial and receive either CBT and medication, or just medication alone for 12 months, to see which approach is the most effective.  Researchers will also evaluate the cost-effectiveness of the treatment and patients' views and experiences of it.  

“CBT has been shown to help patients with previously untreated depression but there is currently little evidence about what alternative treatments doctors should discuss with patients if they have not responded to antidepressants,” says Dr Wiles. “Improving access to psychological therapies is a Government priority, so studies such as this to help inform the development of services in this area.”

Another HTA-funded study will evaluate the effectiveness of group CBT in the prevention of depression in high risk adolescents.  The £1 million trial, led by Professor Paul Stallard at the University of Bath involves Professor Ricardo Araya, Professor Glyn Lewis and Dr Alan Montgomery from Bristol University.

It aims to test whether a school-based depression prevention programme, the Resourceful Adolescent Programme (RAP) developed in Australia, is effective in reducing depressive symptoms in high risk children in the UK.  RAP involves sessions led by trained and supervised mental health professionals. Approximately 20 per cent of pupils per class could be labelled as high risk.

Researchers will invite children aged 13-16 from 9-12 mixed comprehensive schools in Bath, Bristol, Nottingham and Swindon to complete a screening questionnaire.  The scores from these will be used to identify and categorise children as either low risk, high risk of depression or probably depressed.  Whole classes of children will then be randomly assigned to receive either RAP, a placebo intervention or treatment as usual, Personal Health and Social Education - PHSE.

The HTA programme is a programme of the National Institute for Health Research (NIHR) and produces high quality research information about the effectiveness, costs, and broader impact of health technologies for those who use, manage and provide care in the NHS.  It is the largest of the NIHR programmes and publishes the results of its research in the Health Technology Assessment journal.  All issues are available for download free of charge.  The HTA programme is coordinated by the National Coordinating Centre for Health Technology Assessment (NCCHTA), based at the University of Southampton.

http://www.bris.ac.uk/