Telephone-administered psychotherapy for depression.
BACKGROUND
Several studies have shown that telephone-administered cognitive-behavioral therapy (T-CBT) is superior to forms of no treatment controls. No study has examined if the skills-training component to T-CBT provides any benefit beyond that provided by nonspecific factors.


OBJECTIVE
To test the efficacy of a 16-week T-CBT against a strong control for attention and nonspecific therapy effects.


METHODS
Randomized controlled trial including 12-month follow-up.


METHODS
Telephone administration of psychotherapy with patients in their homes.


METHODS
Participants had depression and functional impairments due to multiple sclerosis.


METHODS
A 16-week T-CBT program was compared with 16 weeks of telephone-administered supportive emotion-focused therapy.


METHODS
Hamilton Depression Rating Scale score, Structured Clinical Interview for DSM-IV diagnosis of major depressive disorder, Beck Depression Inventory score, and Positive Affect scale score of the Positive and Negative Affect Scale.


RESULTS
Of the 127 participants randomized, 7 (5.5%) dropped out of treatment. There were significant improvement during treatment on all outcome measures (P<.01 for all) and an increase in Positive Affect Scale score. Improvements over 16 weeks of treatment were significantly greater for T-CBT, compared with telephone-administered supportive emotion-focused therapy, for major depressive disorder frequency (P = .02), Hamilton Depression Rating Scale score (P = .02), and Positive Affect Scale score (P = .008), but not for the Beck Depression Inventory score (P = .29). Treatment gains were maintained during 12-month follow-up; however, differences across treatments were no longer evident (P > .16 for all).


CONCLUSIONS
Patients showed significant improvements in depression and positive affect during the 16 weeks of telephone-administered treatment. The specific cognitive-behavioral components of T-CBT produced improvements above and beyond the nonspecific effects of telephone-administered supportive emotion-focused therapy on evaluator-rated measures of depression and self-reported positive affect. Attrition was low.
Mohr
David C
DC
Veterans Administration Medical Center, University of California, San Francisco 94121, USA. dmohr@itsa.ucsf.edu
Hart
Stacey L
SL
Julian
Laura
L
Catledge
Claudine
C
Honos-Webb
Lara
L
Vella
Lea
L
Tasch
Edwin T
ET
D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006233:Persons with Disabilities / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000453:epidemiology / Q000523:psychology; D010352:Patient Dropouts; D010555:Personality Inventory; D011569:Psychiatric Status Rating Scales; D019114:Remote Consultation / Q000379:methods*; D013689:Telephone / Q000706:statistics & numerical data*; D016896:Treatment Outcome