Question marks over CBT drive for mild depression
The Government's drive to make cognitive behavioural therapy more widely available for patients with mild depression has been challenged by new evidence-based guidelines.
New guidance from the British Association for Psycho-pharmacology (BAP) concludes evidence is lacking for the effectiveness of CBT over other forms of psychological support for mild depression.
The criticism is a blow to the Department of Health, which has earmarked £170m to recruit and train an extra 3,600 therapists to the Improving Access to Psychological Therapies (IAPT) programme by 2011.
NICE currently recommends at least six to eight CBT sessions over 10 to 12 weeks for patients with mild or moderate depression.
But this approach has been challenged by the new BAP guidelines, which also found there was evidence for the effectiveness of antidepressants for the treatment of all forms of depression, with effectiveness increasing with severity.
Dr Ian Anderson, honorary consultant psychiatrist at the University of Manchester and chair of the guidance review group, called on NICE to conduct a thorough cost-effectiveness study before the IAPT roll-out of CBT to patients with mild depression.
He said: ‘There is often not a level playing field in considering evidence for drugs versus psychological treatment, especially in milder depression. We need comparison against appropriate control treatment like non-specific supportive treatment, in the same way as drugs are compared against placebo.
‘This is important given the rolling out of CBT for milder depression – probably less expensive means of support are more cost-effective.'Antidepressants How the guidance conflics with NICE