Enhanced CBT can radically reduce long-term depression, finds study

Enhanced versions of the most commonly used talking therapy for depression significantly reduces the illness beyond six months, a meta study of over 15,000 people has concluded.

The assessment of data from 157 studies of cognitive behavioural therapy led by University of Manchester and University of South Wales scientists has been published in the British Journal of Psychiatry.

The study compared CBT alone and with one or two additional components such as social skills training, assertiveness training, relaxation techniques and psychoeducation.

All three protocols, they found, reduced depressive symptoms by a substantial 8.44 points on the Beck Depression Inventory, a 21 item self-reporting scale which measures symptoms of depression.

However only CBT with one or two additional components sustained the effects in the long-term, reducing depression to at least 5 or 8 points respectively after 6 months when compared to CBT alone.

In addition, CBT given with two extra components was more effective when delivered by non-mental health specialists such as nurses.

Age also appeared to affect the effectiveness of CBT: participants younger than 30 and younger than 59 responded better to CBT with two or one extra components respectively.

And the analyses also demonstrated that participants from lower socio-economic status responded better to CBT with two or one extra components.

Lead author Dr Ioannis Angelakis said: “Depression is the most common mental health condition with more than 264 million people being affected worldwide.

“It impacts negatively on people’s quality of life and is very costly for health and care systems, so understanding how to best to treat it is paramount.

“Our study shows that CBT can significantly reduce depression after treatment, however when given with one or two extra components it becomes effective in the long term.”

He added: “When enhanced CBT is given to younger people, policy makers should also focus on supporting non mental health professionals in giving this extra help.

“A nurse providing enhancements may also play the role of the main care co-ordinator for wider range of health problems.

“That could explain why enhanced CBT seems more effective when they deliver it however more research is needed to understand this more fully.”

Dr Maria Panagioti, a senior lecturer in Primary Care and senior author on the paper is partly funded by the NIHR Greater Manchester Patient Safety Translational Research Centre.

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