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Rumination-focused cognitive behaviour therapy for non-responsive chronic depression: an uncontrolled group study

Published online by Cambridge University Press:  18 October 2019

Stine Bjerrum Moeller*
Affiliation:
Mental Health Centre North Zealand, Psychiatric Research Unit, Mental Health Centre North Zealand, Dyrehavevej 48, DK-3400 Hilleroed, Denmark Stolpegaard Psychotherapeutic Centre, Mental Health Services, Capital Region Denmark
Stephen F. Austin
Affiliation:
Mental Health Centre North Zealand, Psychiatric Research Unit, Mental Health Centre North Zealand, Dyrehavevej 48, DK-3400 Hilleroed, Denmark Psychiatric Research Unit, Region Zealand Psychiatry, Denmark
Morten Hvenegaard
Affiliation:
Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen K, Denmark
Morten Kistrup
Affiliation:
Mental Health Centre North Zealand, Psychiatric Research Unit, Mental Health Centre North Zealand, Dyrehavevej 48, DK-3400 Hilleroed, Denmark Stolpegaard Psychotherapeutic Centre, Mental Health Services, Capital Region Denmark
Stine Gran
Affiliation:
Mental Health Centre North Zealand, Psychiatric Research Unit, Mental Health Centre North Zealand, Dyrehavevej 48, DK-3400 Hilleroed, Denmark
Ed Watkins
Affiliation:
SMART Lab, University of Exeter, Exeter EX4 4QG, UK
*
*Corresponding author. Email: [email protected]

Abstract

Background:

One-third of patients with depression do not respond satisfactorily to treatment, and approximately 20% of all patients treated for depression develop a chronic depression. One approach to more effective treatment of chronic and treatment-resistant depression is to target rumination – an underlying mechanism implicated in the development and maintenance of depression.

Aim:

The purpose of this uncontrolled group study was to investigate the feasibility of individual rumination-focused cognitive behavioural therapy (RfCBT) for patients with chronic and treatment-resistant depression.

Method:

A total of 10 patients with chronic and treatment-resistant depression were offered 12–16 individual sessions of RfCBT. The primary outcome was depressive symptoms as measured by Hamilton Depression Scale at pre-, post- and 3-month follow-up. Secondary symptoms measured included self-reported rumination and worry.

Results:

There was a significant reduction in depressive symptoms (p < 0.05), rumination (p < 0.01) and worry (p < 0.5) from pre- to post-treatment. Half of the participants (n = 5) showed significant reliable change on levels of depressive symptoms post-treatment. The reduction in depressive symptoms, rumination and worry were maintained at follow-up.

Conclusions:

RfCBT was associated with significant reductions in depressive symptoms in a small sample with chronic and treatment-resistant depression. Despite limitations of being a small uncontrolled study with limited follow-up, these results are promising in a difficult to treat population. RfCBT warrants further systematic evaluation.

Type
Brief Clinical Report
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019

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