CBT in depression

Cognitive methods are used to challenge the patient's negative assumptions about their relation to the world and the future. These maladaptive assumptions result in a negative perceptional bias such that every experience is perceived as undermining the patient.

Negative thought processes underpin the social withdrawal and reduced motivation and activity.

Cognitive behavioural therapy (CBT) is at least as good as standard antidepressants in treating established depression. There is evidence that CBT is effective in preventing depressive relapses for at least six years

• in patients with recurrent major depression who have been successfully treated with antidepressant drugs, CBT was more effective than clinical management for preventing depression relapses (1). In this study there was a relapse rate of 25% in the CBT group compared with 80% in the clinical management group at 2 years. The differences in relapse rate are maintained over another 4 years with the respective relapse rates changing to 40% and 90% respectively. Note though that this study had a small sample size (45 patients) and this makes the findings more difficult to generalise

Reference:

1. Fava GA et al. Six-year outcome of cognitive behaviour therapy for prevention of recurrent depression. Am J Psychiatry 2004;161:1872-6.