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Independents' Day

CBT 'no benefit' in severe depression

New research has questioned NICE guidance after finding adolescents with moderate or severe depression do not gain added benefit from cognitive behavioural therapy.

Both the institute and the Department of Health have pushed the benefits of psychological therapies, but there are still doubts over how well they work at the more severe end of the depression spectrum.

The study, published online by the BMJ, found that 19 sessions of CBT had no added benefits in adolescents on an SSRI.

In the study, 208 adolescents aged 11 to 17 with moderate to severe depression were divided into two groups, with fluoxetine 30mg the mean dose of primary SSRI in both.

On average there was a decrease in suicidal thoughts and self harm in both groups, but although 'around one in five patients improved with a brief psychosocial intervention', there was no evidence of a protective effect of CBT on suicidal thinking or action.

Study leader Professor Ian Goodyer, professor of child and adolescent psychiatry at the University of Cambridge, said the data suggested 'for depressed patients referred from community settings, the addition of CBT adds little'.

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