amathus

amathus

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#1
GP's should offer CBT to all depressed patients researchers conclude....

Researchers have called for GPs to offer cognitive behavioural therapy (CBT) for all patients that have not responded to antidepressants in a study published in The Lancet Psychiatry.

The research, funded by the National Institute for Health Research Health Technology Assessment, found that CBT reduces anxiety, improves mental health and induces remission in depressed patients when used alongside usual forms of therapy.

The researchers concluded that GPs ‘should discuss referral for CBT with all those for whom antidepressants are not effective’.

It comes after recent calls for GPs to offer a choice of either therapy or medication as an option for first-line treatment after both were found to be equally as effective.

Among the benefits for mental health, the researchers also believe that CBT is a cost-effective method to treat depression and provides ‘benefit, in terms of health-related quality of life’ that is ‘sustained over time and therefore achieved at no additional cost’.

The study considered the long term effects of behavioural therapy by evaluating patients three years after they had initially received CBT alongside usual methods of first-line treatment.

Overall, patients that had received CBT as an adjunct were found to be less depressed than their counterparts and less likely to use antidepressants for a sustained period of time.

(Amy Moore ~ 20/1/2016)
 
Rod Whiteley

Rod Whiteley

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#2
I guess it was this open access article ("Who seeks shall find"):

Long-term effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: follow-up of the CoBalT randomised controlled trial

There was an obvious problem with the design of the experiment, unfortunately. All the patients received the same treatment, except that one group received CBT as well. So the people in that group got more treatment than in the other group. Even if it had been a tiddlywinks tournament they got, not CBT, the fact of getting extra treatment of some sort would be expected to influence the outcome. So the research doesn't necessarily tell us anything about CBT. I'm disappointed, because I'm a fan of CBT. I wish they'd taken the trouble to design the research better.

Another obvious problem is that the current treatment guidelines for treatment resistant depression already recommend:

...discuss the relative merits of different interventions with the person and provide: an antidepressant...or a high-intensity psychological intervention, normally one of the following options: CBT...
So the research only confirms in a half-baked way what we already know.
 
pepecat

pepecat

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#3
Among the benefits for mental health, the researchers also believe that CBT is a cost-effective method to treat depression and provides ‘benefit, in terms of health-related quality of life’ that is ‘sustained over time and therefore achieved at no additional cost’.
And therein lies the problem.......
 
N

notrealname

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#4
Is this IAPT CBT, though? Has anyone, ever, found 6 half our sessions of CBT effective or useful in any way?

Not to sound bitter or anything...just seems a false economy to me.
 
N

notrealname

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#5
There was an obvious problem with the design of the experiment, unfortunately. All the patients received the same treatment, except that one group received CBT as well. So the people in that group got more treatment than in the other group.
Shitting hell, what a colossal waste of money. That basically tells us nothing then, doesn't it? Except more help helps more. Cheers for looking it up and sharing that.
 
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