Cognitive behavioural therapy can be important in treating depression

Academics awarded ‘Research Paper of the Year’ by the Royal College of General Practitioners

A paper involving the University of Exeter, led by researchers from the University of Bristol, has been awarded Research Paper of the Year Award 2016 from the Royal College of General Practitioners (RCGP).

The RCGP Research Paper of the Year Award recognises an individual or group of researchers who have undertaken and published an exceptional piece of research relating to general practice or primary care. The paper “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”was published in the journal Lancet Psychiatry.

The collaboration, which also involved the universities of Oxford, Glasgow, and University College London, examined whether cognitive behavioural therapy (CBT), given in addition to usual care that included antidepressants, was effective and cost-effective in reducing depressive symptoms and improving quality of life over the long-term (3-5 years) in primary care patients with treatment resistant depression, compared with usual care alone.

Professor John Campbell, Professor of General Practice and Primary Care at the University of Exeter, Medical School, said, “Depression is a problem commonly encountered by GPs. Drug treatments don’t always work, and therefore we need to understand more about what ‘next step’ treatments might be useful. Our study highlights the importance of ‘talking therapies’ especially those which offer substantial support to patients, and which this study shows to have long term clinical benefits for patients. In addition, the research shows that such approaches are also cost-effective for the NHS.”

Dr Nicola Wiles, first author of the paper, from the University of Bristol’s Centre for Academic Mental Health, said: “We found that CBT was effective in reducing depressive symptoms over the long-term in patients with depression that had not responded to treatment with antidepressants. Importantly, this treatment also represented good value for money from the perspective of the health service.”

The study, funded by the National Institute for Health Research (NIHR), found that, over the follow-up period, the intervention group were less depressed than the group who continued with usual care from their GP. Those who received CBT were also more likely to experience remission of symptoms and a reduction in symptoms of anxiety compared with those in the usual care group.

Dr Wiles also said: “Our results also highlight the importance of investment in psychological services. The main focus of initiatives to increase access to such treatments, in both England and Australia, has been in increasing the provision of ‘low intensity’ treatments, such as computerised CBT packages and guided self-help. Our study suggests that, by investing in ‘high intensity’ CBT as delivered in this trial, it may be possible to reduce the significant burden to patients and health care systems that is associated with non-response to the most common treatment for depression”.  

Further information

Paper

‘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 byNicola J Wiles, Laura Thomas, Nicholas Turner, Kirsty Garfield, Daphne Kounali, John Campbell, David Kessler, Willem Kuyken, Glyn Lewis, Jill Morrison, Chris Williams, Tim J Peters, Sandra Hollinghurst in The Lancet Psychiatry 2016 3(2): 137-144 (http://dx.doi.org/10.1016/S2215-0366(15)00495-2).

About the NIHR

The National Institute for Health Research (NIHR): improving the health and wealth of the nation through research.

Established by the Department of Health, the NIHR:

• funds high quality research to improve health

• trains and supports health researchers

• provides world-class research facilities

• works with the life sciences industry and charities to benefit all

• involves patients and the public at every step

For further information, visit the NIHR website www.nihr.ac.uk

Date: 12 October 2017