title: Metacognitive therapy versus cognitive behavioural therapy for depression: a randomized pilot study.
abstract: OBJECTIVE
  Metacognitive therapy (MCT) is one of the newer developments within cognitive therapy. This randomized controlled pilot study compared independently applied MCT with cognitive behavioural therapy (CBT) in outpatients with depression to explore the relative speed and efficacy of MCT, ahead of a planned randomized controlled trial.
  
  
  METHODS
  A total of 48 participants referred for outpatient therapy were randomized to up to 12 weeks of MCT or CBT. Key outcomes were reduction in depressive symptoms at week 4 and week 12, measured using the independent-clinician-rated Quick Inventory of Depressive Symptomatology16. Intention-to-treat and completer analyses as well as additional methods of reporting outcome of depression are presented.
  
  
  RESULTS
  Both therapies were effective in producing clinically significant change in depressive symptoms, with moderate-to-large effect sizes obtained. No differences were detected between therapies in overall outcome or early change on clinician-rated or self-reported measures. Post-hoc analyses suggest that MCT may have been adversely affected by greater comorbidity.
  
  
  CONCLUSIONS
  In this large pilot study conducted independently of MCT's developers, MCT was an effective treatment for outpatients with depression, with similar results overall to CBT. Insufficient power and imbalanced comorbidity limit conclusions regarding comparative efficacy so further studies of MCT and CBT are required.
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand Clinical Research Unit, Canterbury District Health Board, Christchurch, New Zealand jenny.jordan@otago.ac.nz.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jordan
authors.affiliation: Psychology Department, University of Canterbury, Christchurch, New Zealand.
authors.forename: Janet D
authors.initials: JD
authors.lastname: Carter
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand Clinical Research Unit, Canterbury District Health Board, Christchurch, New Zealand.
authors.forename: Virginia V W
authors.initials: VV
authors.lastname: McIntosh
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Kumari
authors.initials: K
authors.lastname: Fernando
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Christopher M A
authors.initials: CM
authors.lastname: Frampton
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Porter
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Roger T
authors.initials: RT
authors.lastname: Mulder
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand Maori Indigenous Health Institute, University of Otago, Christchurch, New Zealand.
authors.forename: Cameron
authors.initials: C
authors.lastname: Lacey
authors.affiliation: Department of Psychological Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Joyce
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D016896:Treatment Outcome; D055815:Young Adult
keywords: Cognitive behavioural therapy; depression; metacognitive; randomized pilot study