title: Cognitive self-therapy for chronic depression and anxiety: a multi-centre randomized controlled study.
abstract: 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.
authors.affiliation: Department of Psychiatry, University Medical Center Groningen, University of Groningen, The Netherlands. p.c.a.m.den.boer@psy.umcg.nl
authors.forename: Peter C A M
authors.initials: PC
authors.lastname: den Boer
authors.forename: Durk
authors.initials: D
authors.lastname: Wiersma
authors.forename: Inge
authors.initials: I
authors.lastname: Ten Vaarwerk
authors.forename: Mark M
authors.initials: MM
authors.lastname: Span
authors.forename: A Dennis
authors.initials: AD
authors.lastname: Stant
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Van den Bosch
mesh_terms: 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