A pilot randomised controlled trial of a brief cognitive behavioural group intervention to reduce recurrence rates in late life depression.
OBJECTIVE
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.


METHODS
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 Asberg Rating Scale for Depression (MADRS).


CONCLUSIONS
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.
Wilkinson
Philip
P
Department of Psychiatry, University of Oxford, Oxford, UK. philip.wilkinson@psych.ox.ac.uk
Alder
Nicola
N
Juszczak
Edmund
E
Matthews
Helen
H
Merritt
Claire
C
Montgomery
Harriet
H
Howard
Robert
R
Macdonald
Alastair
A
Jacoby
Robin
R
D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D010865:Pilot Projects; D011614:Psychotherapy, Brief / Q000379:methods*; D011615:Psychotherapy, Group / Q000379:methods*; D012044:Regression Analysis; D055502:Secondary Prevention; D016896:Treatment Outcome
D000928:Antidepressive Agents