10 Dec 2012 00:56
Antidepressants are the most widely used treatment for people with moderate to severe depression. However, up to two thirds of people with depression don't respond fully to this type of treatment. New findings, published in The Lancet, have shown cognitive behavioural therapy (CBT)*, provided in addition to usual care, can reduce symptoms of depression and help improve patients' quality of life.
This is the first large-scale trial to test the effectiveness of CBT - a type of talking psychotherapy - given in addition to usual care that includes antidepressants. The National Institute for Health Research Health Technology Assessment (NIHR HTA) Programme-funded CoBalT study aimed to determine the best 'next step' treatment for people whose depression had not responded to medication alone.
The CoBaIT team, comprising researchers from the Universities of Bristol, Exeter and Glasgow, recruited 469 patients aged 18- to 75-years with treatment-resistant depression for the randomised controlled trial. Patients were split into two groups: 235 patients continued with their usual care from the GP, which included continuing on antidepressant medication, and 234 patients were treated with CBT in addition to usual care from their GP. Researchers followed-up 422 patients (90%) at six months and 396 (84%) at 12 months to compare their progress.
At six months, 46% of those who received CBT in addition to usual care had improved, reporting at least a 50% reduction in symptoms of depression, compared to 22% of those who continued with usual care alone. This beneficial effect was maintained over 12 months.
The findings demonstrate that CBT provided in addition to usual care including antidepressant medication is an effective treatment that reduces depressive symptoms, and improves the quality of life in patients whose depression has not responded to the most common first-line treatment for depression in primary care.
Dr Nicola Wiles, the study's lead author and a Senior Lecturer in the University of Bristol's School of Social and Community Medicine, said: "Antidepressants are often the first-line treatment for depression - a major public health problem with the World Health Organisation estimating that over 300 million people are affected globally. However, in many countries, access to psychological treatments such as CBT is limited to people who can afford to pay, or those with health insurance. These findings emphasise the importance of increasing the availability of psychological therapy. While there have been initiatives to increase access to such treatments in both the UK and Australia, worldwide initiatives are rare, and even in the UK many people who have not responded to antidepressants do not get psychological treatment. Our study suggests that by investing in psychological services it is possible to reduce the significant burden to patients and healthcare systems that is associated with non-response to antidepressant medication.
"Furthermore, it is important to acknowledge that while we found CBT was an effective treatment for this patient group, not everyone who received CBT improved. It is therefore essential that we invest in further research in this area to investigate alternative treatment options, both pharmacological and non-pharmacological, for the significant number of patients whose depression does not get better following treatment with antidepressants."
Willem Kuyken, Professor of Clinical Psychology at the University of Exeter, added: "This trial provides further evidence that psychological treatments like cognitive therapy can provide substantive and lasting help to people who suffer depression. The Mood Disorders Centre, one of the participating sites, aims to make evidence-based psychological approaches as accessible as possible to people suffering depression. This trial demonstrates that people with complex and longstanding needs who have not responded to antidepressants can derive substantive and lasting benefit from CBT delivered by well trained therapists. Showing that 40% of people who had been in cognitive therapy were largely free of symptoms at 12 months is really important because it bodes well for their longer-term recovery."
John Campbell, Professor of General Practice at the University of Exeter Medical School, commented: "Depression is a very common illness, encountered frequently by GPs and their patients. While drug treatments can be very effective, not all patients will respond well to treatment. For some patients, the experience of depression can be particularly difficult. We were delighted that so many patients, GPs, and practices helped us with this research. The results we present today show that for some patients, the addition of a 'talking therapy' such as CBT can be very effective in treating the depression and helping resolve disabling symptoms. GPs and their patients can take real encouragement from these findings which provide real support for the use of CBT in patients where other treatments may have failed."
Chris Williams, Professor of Psychosocial Psychiatry at the University of Glasgow, added: "This research is also of great importance because it used a CBT intervention alongside treatment with antidepressants. It confirms how these approaches - the psychological and physical - treatments can complement each other. It was also encouraging because we found the approach worked to good effect across a wide range of people of different ages and living in a variety of settings."
Emer O'Neill, Chief Executive of Depression Alliance, the leading UK charity for people affected by depression, added: "Over the last few years there has been a significant improvement in lifting the stigma associated with depression, and the services available to help treat it.
"However, this marks just the beginning as for many years our members have been asking for access to a wide range of peer-support services. We are delighted to see this research as it now provides the evidence that a range of treatments such as cognitive behavioural therapy and medication is vital to continuing this success."
Source: Bristol University
IN THE WORKPLACE
Research on Depression in the Workplace.
For more information please click here
Mental Health Matters Journal for Psychiatrists & GP's
Click here for more info on articles & how to subscribe
Literacy is a luxury that many of us take for granted. We depend on written communication for information, guidance, and access to heath care information That is why SADAG created SPEAKING BOOKS and revolutionized the way information is delivered to low literacy communities. It's exactly what it sounds like.a book that talks to the reader in his or her local language, delivering critical information in an interactive, and educational way.
The customizable 16-page book, accompanied by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood..
We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 30 titles, such as TB, Malaria, Polio, Vaccines for over 30 countries.
- Click here to see speaking books in action
- Click here for sample book on clinical trials
- Click here for latest press release 1.
- Click here for latest press release 2.
- Click here to connect to international site www.booksofhope.com
- Speaking books for Health Care YouTube
Cognitive behavioural therapy effective where antidepressants have failed
10 Dec 2012 00:56
Dr Reddy's Help Line
0800 21 22 23
Cipla 24hr Mental Health Helpline
0800 456 789
Pharmadynamics Police &Trauma Line
0800 20 50 26
Adcock Ingram Depression and Anxiety Helpline
0800 70 80 90
0800 55 44 33
Department of Social Development Substance Abuse Line 24hr helpline
0800 12 13 14
Suicide Crisis Line
0800 567 567
SADAG Mental Health Line
011 234 4837
Akeso Psychiatric Response Unit 24 Hour
0861 435 787
Cipla Whatsapp Chat Line
076 882 2775
EMERGENCY Contact Numbers for Students in South Africa - Click here
MENTAL HEALTH CALENDAR 2020
Teen Suicide Prevention Week
16 - 23 February
World Bipolar Day
Bipolar Awareness Day
Substance Abuse Awareness Day
Mental Health Awareness Month
1 – 31 July
Panic Awareness Day
World Suicide Prevention Day
World Mental Health Day
View our list of informative Infographs.
SADAG KZN Branch
SADAG has an office in Durban with the support of Psychiatrist Dr Suvira Ramlall and Clinical Psychologist, Suntosh Pillay.
The office is based at the University of KwaZulu-Natal (UKZN), Howard College Campus, 238 Mazisi Kunene Road, Durban; and is managed by Lynn Norton
The KZN Branch is deeply committed to:
- Launching new Support Groups
- Workshops on Mental Health
- School Talks on Suicide Prevention
- Corporate Wellness For KZN companies
- Mental health advocacy and activism
Please click here for more information about the KZN activities.
Want to become a volunteer counsellor? Contact Senzi or Krystle 011 234 4837
Download Application Form Here
If you are interested in starting a Support Group, please contact Krystle on 0800 21 22 23.
To find a Support Group in your area, please phone SADAG on 0800 21 22 23.
If you are a journalist writing a story contact Cassey or Kayla or Tracy on 011 234 4837 /email@example.com