Cognitive self-therapy for chronic depression and anxiety: a multi-centre randomized controlled study.
BACKGROUND
Non-professional treatment programmes are presumed to relieve the extensive need for care of anxiety and depression disorders. This study investigates the effectiveness of cognitive self- therapy (CST) in the treatment of depression or generalized anxiety disorder.


METHODS
Patients (n=151) were randomized to receive CST or treatment as usual (TAU) in a trial lasting for 18 months, measuring symptoms (SCL-90; main outcome), social functions, quality of life and utilization of care.


RESULTS
Patients in both conditions improved significantly, but no difference was found between the conditions. Reduction of symptoms, improvement of social functions and medical utilization were maintained at the end of the 18 months. Medical care utilization (therapist contact and hospitalization) was lower for CST than for TAU. No suicides occurred.


CONCLUSIONS
Cognitive self-therapy is likely to decrease the need for care of chronic depression and anxiety disorders, but it has not been proven to be more effective than treatment as usual.
den Boer
Peter C A M
PC
Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands. p.c.a.m.den.boer@psy.umcg.nl
Wiersma
Durk
D
Ten Vaarwerk
Inge
I
Span
Mark M
MM
Stant
A Dennis
AD
Van den Bosch
Robert J
RJ
D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D015897:Comorbidity; D003866:Depressive Disorder / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008605:Mental Health Services / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands; D011788:Quality of Life / Q000523:psychology; D012648:Self Care / Q000523:psychology*; D012917:Social Adjustment; D016896:Treatment Outcome; D014600:Utilization Review