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Use CBT for treatment-resistant depression, GPs told

GPs should consider referring for cognitive behavioural therapy in patients with treatment-resistant depression, say the results of a new trial.

UK researchers randomised 469 adult patients with treatment-resistant depression - i.e. symptoms despite adherence to an antidepressant for at least six weeks - to receive either CBT as an adjunct to usual care or usual care alone.

Patients undergoing CBT as an adjunct to usual GP care were more than three times as likely to experience a 50% reduction in depressive symptoms, compared to patients who underwent usual care alone.

They were also more than two times likely to go into remission, defined as a Beck Depression Index score of less than 10, compared to patients being treated by usual GP care.

There were no restrictions placed on GPs when it came to usual care, while the intervention group received 12 sessions of CBT.

The UK researchers say this is the first large scale randomised controlled trial showing CBT is an effective next-step for depressed patients who have not responded to pharmacotherapy.

Lancet 2012, available online 7 December



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