CBT in depression

Cognitive methods are used to challenge the patient's negative assumptions about their relation to the world and the future. These maladaptive assumptions result in a negative perceptional bias such that every experience is perceived as undermining the patient.

Negative thought processes underpin the social withdrawal and reduced motivation and activity.

Cognitive behavioural therapy (CBT) is at least as good as standard antidepressants in treating established depression and CBT has shown greater efficacy than pharmacological placebo across levels of severity. (1) Treatment response to CBT is comparable with antidepressant response in some studies. (2)

CBT also appears to have an enduring effect that reduces subsequent risk after treatment ends (1) and adjunctive CBT has also been found to improve outcomes for depression treatment in the primary care setting. (3)

Reference

1. Furukawa TA, Weitz ES, Tanaka S, et al. Initial severity of depression and efficacy of cognitive-behavioural therapy: individual-participant data meta-analysis of pill-placebo-controlled trials. Br J Psychiatry. 2017 Mar;210(3):190-6.
2. Gartlehner G, Wagner G, Matyas N, et al. Pharmacological and non-pharmacological treatments for major depressive disorder: review of systematic reviews. BMJ Open. 2017 Jun 14;7(6):e014912.
3. Wiles N, Thomas L, Abel A, et al. Clinical effectiveness and cost-effectiveness of cognitive behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: the CoBalT randomised controlled trial. Health Technol Assess. 2014 May;18(31):1-167.