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Low-intensity talking therapy 'does not prevent depression relapse'

Brief talking therapy for depression, as recommended by NICE, may not be sufficient to prevent relapse, as a recent study found over half of patients displayed clinical symptoms a year after treatment. 

The study, published in Behaviour Research and Therapy, looked at 439 patients who received low intensity cognitive behavioural therapy (LiCBT), a simplified version of the widely-used form of talking therapy.

LiCBT generally involves weekly patient contact and typically lasts under two months.

Participants in the study completed monthly depression (PHQ-9) and anxiety (GAD-7) measures for 12 months after treatment.

As well as a 53% relapse rate among LiCBT patients after 12 months, the authors also found that those with residual depressive symptoms were twice as likely to suffer relapse.

Some 79% of relapses occurred in the first six months after treatment. The authors found a hazard ratio of 1.9 associated with the reporting of residual symptoms at the end of treatment and experiencing a relapse.

NICE recommends the use of low intensity psychosocial interventions or group CBT in cases of mild to moderate depression.

Lead author Dr Shehzad Ali, research fellow, at the  Department of Health Sciences at the University of York, said: 'Our research highlights that, under the current system, some patients are being discharged too soon.'

'Patients who have low levels of depression at the time of discharge are more likely to relapse within a few months.'

The study's co-author Dr Jaime Delgadillo, from the Clinical Psychology Unit at the University of Sheffield, said: 'These findings underline the importance of monitoring patients' wellbeing for at least six months after treatment.

'Incomplete or insufficient treatment also costs the NHS, as patients who relapse often need further care or support.'

There is still limited evidence regarding its long-term effectiveness in treating depression and anxiety.

Previous attempts at making CBT more scalable, such as using computer-based versions of therapy, showed no benefit, due to low patient adherence.

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