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CBT reduced depression in patients unresponsive to antidepressants

Cognitive behavioral therapy in addition to usual care that included antidepressants reduced depressive symptoms and improved quality of life for patients, according to study results from the CoBalT trial.

“These findings emphasize the importance of increasing the availability of psychological therapy,” study researcher Nicola Wiles, PhD, of the Centre for Mental Health, Addiction and Suicide Research at the University of Bristol, said in a press release.

The CoBalT trial is a randomized controlled trial with two parallel groups drawn from 73 general practices in the United Kingdom. Wiles and colleagues compared the treatment outcomes of 469 patients aged 18 to 75 years with treatment-resistant depression after receiving antidepressants for more than 6 weeks. For the study, 235 patients continued with their usual care from their general practitioner and 234 patients were treated with cognitive behavioral therapy (CBT) in addition to usual care. Patients were followed up at 6 and 12 months.

Treatment response was defined in the study as “a reduction in depressive symptoms of at least 50% compared with baseline.”

Results indicated that 46% of participants in the CBT group met criteria for treatment response at 6 months vs. 22% of those in usual care (OR=3.26; 95% CI, 2.1-5.06). The CBT group also showed improvement in quality of life (P<.001). In addition, participants in the CBT group were more likely to experience remission (OR=2.3; 95% CI, 1.39-3.81). Compared with participants who received usual care, those in the CBT group were almost three times more likely to meet criteria for treatment response over 12 months (OR=2.89; 95% CI, 2.03-4.1).

“It is important to acknowledge that while we found CBT was an effective treatment for this patient group, not everyone who received CBT improved,” Wiles said. “It is therefore essential that we invest in further research in this area to investigate alternative treatment options, both pharmacological and non-pharmacological, for the significant number of patients whose depression does not get better following treatment with antidepressants.”

Disclosure: Wiles reports no relevant financial disclosures. See the study for a full list of the other researchers’ financial disclosures.