alexa Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners’ Care for Depression: A Randomised Trial
ISSN: 2167-1044

Journal of Depression and Anxiety
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Research Article

Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners’ Care for Depression: A Randomised Trial

Schene AH1,6,7*, Baas KD1, Koeter MWJ1, Lucassen P3, Bockting CLH4, Wittkampf KA1,2, Huyser J5 and van Weert HC2
1 Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
2 Department of General Practice, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
3 Department of Primary and Community Care, Radboud University Nijmegen, Nijmegen, The Netherlan
4 Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
5 Business Unit Curative Care Arkin, Amsterdam, The Netherlands.
6 Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
7 Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, The Netherlands
*Corresponding Author : Aart Schene
Department of Psychiatry
Radboud University Medical Center
Nijmegen, The Netherlands
Tel: 0031243610674
E-mail: [email protected]
Received March 14, 2014; Accepted April 24, 2014; Published April 29, 2014
Citation: Schene AH, Baas KD, Koeter MWJ, Lucassen P, Bockting CLH, et al. (2014) Brief Cognitive Behavioural Therapy Compared to Optimised General Practitioners’ Care for Depression: A Randomised Trial. J Depress Anxiety S2:001. doi:10.4172/2167-1044.S2-001
Copyright: © 2014 Schene AH, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

Abstract

Background: How to treat Major Depressive Disorder (MDD) in primary care? Studies that compared (brief) Cognitive Behavioural Therapy (CBT) with care as usual by the General Practitioner (GP) found the first to be more effective. However, to make a fair comparison GP care should be optimised and protocolised according to current evidence based guidelines for depression. So far this has not been the case. We studied whether a protocolised 8 session CBT is more effective than optimised and protocolised GP care (GPC). Methods: 121 patients with MDD, age 18-70 years, from 40 Dutch general practices, were randomised to either brief CBT or GPC. Assessments were at baseline (t0), 12 weeks (t1) and 52 weeks (t2). Main outcomes: decrease in depressive symptoms, response and remission on the Hamilton Depression Rating Scale-17 (HDRS-17) and the Patient Health Questionnaire-9 (PHQ-9). (Trial registration: ISRCTN65811640). Results: Both continuous and dichotomous HDRS-17 and PHQ-9 outcome scores favoured the brief CBT group. Number of treatment contacts and external referrals were not different between groups. GPs prescribed antidepressants (AD) to 48% of GPC patients and to 11% of CBT patients. Conclusions: Brief CBT by psychologists seems more effective than optimized GPC. Effect sizes comparable to the (statistical significant) results from meta-analyses, together with lower AD prescriptions, are both in favour of brief CBT which might make it a first choice treatment for patients with MDD in general practice.

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