title: Long-term effects of cognitive therapy on biological rhythms and depressive symptoms: A randomized clinical trial.
abstract: OBJECTIVE
  To evaluate the effect of cognitive therapy on biological rhythm and depressive and anxious symptoms in a twelve-month follow-up period. In addition, correlations between the reduction of depression and anxiety symptoms and the regulation of biological rhythm were observed.
  
  
  METHODS
  This was a randomized clinical trial with young adults from 18 to 29 years of age who were diagnosed with depression. Two models of psychotherapy were used: Cognitive Behavioral Therapy (CBT) and Narrative Cognitive Therapy (NCT). Biological rhythm was assessed with the Biological Rhythm Interview of Assessment in Neuropsychiatry (BRIAN). Severity of depressive and anxious symptoms was assessed by the Hamilton Depression Rating Scale (HDRS) and the Hamilton Anxiety Rating Scale (HARS), respectively. The sample included 97 patients who were divided within the protocols of psychotherapy.
  
  
  RESULTS
  There was a significant reduction in depressive and anxious symptoms (p<0.001) and an increase on regulation of biological rhythm (p<0.05) at the twelve-month follow-up. Moreover, we showed a positive correlation between the reduction of depressive symptoms and regulation of biological rhythm (r=0.638; p<0.001) and between the reduction of anxious symptoms and regulation of biological rhythm (r=0.438; p<0.001).
  
  
  CONCLUSIONS
  Both models showed that cognitive therapy was effective on the reduction of depressive and anxious symptoms and on the regulation of biological rhythm at a twelve-month follow-up evaluation. This study highlights the association between biological rhythm and symptoms of depression and anxiety.
  
  
  CONCLUSIONS
  We did not assess genetic, hormonal or neurochemical factors and we did not include patients under pharmaceutical treatment or those with severe symptomatology.
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Brazil.
authors: Thaíse Campos
authors: TC
authors: Mondin
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Brazil.
authors: Taiane de Azevedo
authors: Tde A
authors: Cardoso
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Brazil.
authors: Karen
authors: K
authors: Jansen
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Brazil.
authors: Giovanna Del Grande da
authors: Gdel G
authors: Silva
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Brazil.
authors: Luciano Dias de Mattos
authors: LD
authors: Souza
authors: Universidade Católica de Pelotas, Programa de Pós-Graduação em Saúde e Comportamento, Brazil. Electronic address: ricardo.as@uol.com.br.
authors: Ricardo Azevedo da
authors: RA
authors: Silva
mesh_terms: D000293:Adolescent; D001008:Anxiety Disorders / Q000523:psychology / Q000628:therapy; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000628:therapy; D003866:Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D062525:Narrative Therapy; D010507:Periodicity; D011569:Psychiatric Status Rating Scales; D013995:Time; D055815:Young Adult
keywords: Biological rhythm; Cognitive behavior psychotherapy; Depression; Narrative cognitive psychotherapy