Premium
A pilot randomised controlled trial of a brief cognitive behavioural group intervention to reduce recurrence rates in late life depression
Author(s) -
Wilkinson Philip,
Alder Nicola,
Juszczak Edmund,
Matthews Helen,
Merritt Claire,
Montgomery Harriet,
Howard Robert,
Macdonald Alastair,
Jacoby Robin
Publication year - 2009
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.2076
Subject(s) - rating scale , depression (economics) , randomized controlled trial , cognitive behavioral therapy , beck depression inventory , medicine , cognitive therapy , montgomery–åsberg depression rating scale , physical therapy , late life depression , clinical trial , psychology , cognition , psychiatry , major depressive disorder , anxiety , developmental psychology , economics , macroeconomics
Objectives To standardise the delivery of a brief group cognitive behaviour therapy intervention (CBT‐G). To apply the intervention in a research setting and to estimate its effect on recurrence rates in recently depressed older adults, in preparation for a definitive study. Method A CBT‐G therapy manual was produced and the Cognitive Therapy Rating Scale (CTS‐R) modified to assess therapy delivery. Forty‐five adults aged 60 and over who had met ICD‐10 criteria for major depression in the previous year and were still taking antidepressant medication were randomly allocated to CBT‐G/antidepressant combination or antidepressant alone. Depression severity was measured at baseline, randomisation and 6 and 12 months after start of CBT‐G using the Montgomery Åsberg Rating Scale for Depression (MADRS). Results and conclusion One‐year recurrence rates on the MADRS were encouragingly lower in participants receiving CBT‐G [5/18 (27.8%)] compared with controls [8/18 (44.4%)] although this did not achieve statistical significance (adjusted RR 0.70 [95% CI 0.26–1.94]). In contrast, overall scores on the secondary outcome measure, the Beck Depression Inventory, increased in participants receiving CBT‐G. The CBT‐G manual was successfully implemented and therapy delivery achieved an overall satisfactory level of competence. We believe that evaluation of this promising intervention in a full‐scale trial is warranted. Copyright © 2008 John Wiley & Sons, Ltd.