Morten Hvenegaard1, Stine B Moeller2, Stig Poulsen1, Matthias Gondan1, Ben Grafton3, Stephen F Austin2, Morten Kistrup4, Nicole G K Rosenberg5, Henriette Howard6, Edward R Watkins7. 1. Department of Psychology, University of Copenhagen, Copenhagen, Denmark. 2. Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark. 3. Cognition and Emotion Lab, School of Psychology, University of Western Australia, Crawley, Australia. 4. Psychiatric Outpatient Service, Mental Health Centre North Zealand, Hillerød, Denmark. 5. Psychotherapeutic Clinic Nannasgade, Mental Health Centre Copenhagen, Capital Region Mental Health Services, Copenhagen, Denmark. 6. Mental Health Centre for Child and Adolescent Psychiatry, Glostrup, Denmark. 7. Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, UK.
Abstract
BACKGROUND: Although cognitive-behavioural therapy (CBT) is an effective treatment for depression, less than half of patients achieve satisfactory symptom reduction during treatment. Targeting known psychopathological processes such as rumination may increase treatment efficacy. The aim of this study was to test whether adding group rumination-focused CBT (RFCBT) that explicitly targets rumination to routine medical management is superior to adding group CBT to routine medical management in treating major depression. METHODS: A total of 131 outpatients with major depression were randomly allocated to 12 sessions group RFCBT v. group CBT, each in addition to routine medical management. The primary outcome was observer-rated symptoms of depression at the end of treatment measured on the Hamilton Rating Scale for Depression. Secondary outcomes were rumination at post-treatment and depressive symptoms at 6 months follow-up (Trial registered: NCT02278224). RESULTS:RFCBT significantly improved observer-rated depressive symptoms (Cohen's d 0.38; 95% CI 0.03-0.73) relative to group CBT at post-treatment on the primary outcome. No post-treatment differences were found in rumination or in depressive symptoms at 6 months follow-up, although these secondary analyses may have been underpowered. CONCLUSIONS: This is the first randomized controlled trial providing evidence of benefits of RFCBT in major depression compared with CBT. Group RFCBT may be a beneficial alternative to group CBT for major depression.
RCT Entities:
BACKGROUND: Although cognitive-behavioural therapy (CBT) is an effective treatment for depression, less than half of patients achieve satisfactory symptom reduction during treatment. Targeting known psychopathological processes such as rumination may increase treatment efficacy. The aim of this study was to test whether adding group rumination-focused CBT (RFCBT) that explicitly targets rumination to routine medical management is superior to adding group CBT to routine medical management in treating major depression. METHODS: A total of 131 outpatients with major depression were randomly allocated to 12 sessions group RFCBT v. group CBT, each in addition to routine medical management. The primary outcome was observer-rated symptoms of depression at the end of treatment measured on the Hamilton Rating Scale for Depression. Secondary outcomes were rumination at post-treatment and depressive symptoms at 6 months follow-up (Trial registered: NCT02278224). RESULTS:RFCBT significantly improved observer-rated depressive symptoms (Cohen's d 0.38; 95% CI 0.03-0.73) relative to group CBT at post-treatment on the primary outcome. No post-treatment differences were found in rumination or in depressive symptoms at 6 months follow-up, although these secondary analyses may have been underpowered. CONCLUSIONS: This is the first randomized controlled trial providing evidence of benefits of RFCBT in major depression compared with CBT. Group RFCBT may be a beneficial alternative to group CBT for major depression.
Authors: C O'Driscoll; J E J Buckman; E I Fried; R Saunders; Z D Cohen; G Ambler; R J DeRubeis; S Gilbody; S D Hollon; T Kendrick; D Kessler; G Lewis; E Watkins; N Wiles; S Pilling Journal: BMC Med Date: 2021-05-06 Impact factor: 8.775
Authors: A Newbold; F C Warren; R S Taylor; C Hulme; S Burnett; B Aas; C Botella; F Burkhardt; T Ehring; J R J Fontaine; M Frost; A Garcia-Palacios; E Greimel; C Hoessle; A Hovasapian; Vei Huyghe; J Lochner; G Molinari; R Pekrun; B Platt; T Rosenkranz; K R Scherer; K Schlegel; G Schulte-Korne; C Suso; V Voigt; E R Watkins Journal: BMC Psychiatry Date: 2020-09-22 Impact factor: 3.630