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At the heart of general practice since 1960

Don't treat lingering coughs

From Dr C Goldsmith

Norwich

At the risk of sounding like a broken record, I am still bewildered as to why some readers are still in the dark over CBT (News, 26 November).

Margaret Hodge has proposed CBT for some patients demanding sicknotes who may be suffering from anxiety/ depression. Remember that an estimated £2 billion is lost to the economy per year from this disease. Yes we are all aware that CBT practitioners are rare as NHS dentists, and that is why NICE has approved computerised CBT ­ Beating the Blues (BtB) ­ in its final appraisal document. This will soon be released as guidance to the Department of Health.

As I have pointed out before, BtB has been shown in RCTs to be at least as effective as antidepressants, and is cost-effective, requiring little supervision.

Wigan PCT has renewed its licence with BtB for three years after very positive experience. I quote John Marshall, Wigan's mental health commissioner: 'The use of the Relief Series (Ultrasis) fits perfectly with department policies on self-management and choice with regard to mental health issues.

'Since the launch of Wigan in Mind many local people have used the service and, although it is early days, feedback has been very positive.'

Hopefully PCTs will be able to provide access to CBT from next year, thus addressing the problem of 18-month waiting lists to see a therapist and reducing the depression overload on GP practices.

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