title: Metacognitive therapy in treatment-resistant depression: a platform trial.
abstract: Patients with treatment-resistant depression received up to 8 sessions of metacognitive therapy (MCT) targeting attentional control, rumination, worry, and metacognitive beliefs. A baseline period was followed by weekly sessions with follow-up assessments at 6 and 12 months post treatment. Large and statistically significant improvements occurred in all symptom measures at post treatment and were maintained over follow-up. Two out of 3 process measures significantly improved at post treatment and all of these measures were improved at follow-up. Treatment was associated with similar response rates on the BDI and Hamilton rating scale. Using liberal criteria 80% of completers were classified as recovered at post treatment and 70% at follow-up on the BDI. In the intention to treat sample 66.6% were recovered at post treatment and 58.3% at follow-up. More stringent criteria showed 60% recovery rates at post treatment and at 12 m. The results suggest that MCT could be a brief and effective treatment and they provide a precedent for more definitive randomized controlled trials.
authors.affiliation: University of Manchester, UK. adrian.wells@manchester.ac.uk
authors.forename: Adrian
authors.initials: A
authors.lastname: Wells
authors.forename: Peter
authors.initials: P
authors.lastname: Fisher
authors.forename: Samuel
authors.initials: S
authors.lastname: Myers
authors.forename: Jon
authors.initials: J
authors.lastname: Wheatley
authors.forename: Trishna
authors.initials: T
authors.lastname: Patel
authors.forename: Chris R
authors.initials: CR
authors.lastname: Brewin
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000928:Antidepressive Agents / Q000627:therapeutic use; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D061218:Depressive Disorder, Treatment-Resistant / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents