Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-22T12:47:15.388Z Has data issue: false hasContentIssue false
  • English
  • Français

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 Open the ORCID record for Stine Bjerrum Moeller [Opens in a new window] ,
Stephen F. Austin ,
Morten Hvenegaard ,
Morten Kistrup ,
Stine Gran  and
Ed Watkins Open the ORCID record for Ed Watkins [Opens in a new window]
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]
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

chronic treatment-resistant depressionruminationrumination-focused cognitive behaviour therapyuncontrolled group studyworry
Type
Brief Clinical Report
Information
Behavioural and Cognitive Psychotherapy , Volume 48 , Issue 3 , May 2020 , pp. 376 - 381
Copyright
© British Association for Behavioural and Cognitive Psychotherapies 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bech, P., Gram, L. F., Dein, E., Jacobsen, O., Vitger, J., & Bolwig, T. G. (1975). Quantitative rating of depressive states: correlation between clinical assessment, Beck’s Self-Rating Scale and Hamilton’s Objective Rating Scale. Acta Psychiatrica Scandinavica, 51, 161–170.CrossRefGoogle Scholar
Cuijpers, P., van Straten, A., Schuurmans, J., van Oppen, P., Hollon, S. D., & Andersson, G. (2010). Psychotherapy for chronic major depression and dysthymia: a meta-analysis. Clinical Psychology Review, 30, 51–62.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery & Psychiatry, 23, 52–62.CrossRefGoogle ScholarPubMed
Hvenegaard, M., Moeller, S. B., Poulsen, S., Gondan, M., Grafton, B., Austin, S. F., … & Watkins, E. R. (2019). Group rumination-focused cognitive-behavioural therapy (CBT) v. group CBT for depression: phase II trial. Psychological Medicine, 1–9.Google Scholar
Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12.CrossRefGoogle ScholarPubMed
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn Sate Worry Questionnaire. Behaviour Research and Therapy, 28, 487–495.CrossRefGoogle Scholar
Negt, P., Brakemeier, E. L., Michalak, J., Winter, L., Bleich, S., & Kahl, K. G. (2016). The treatment of chronic depression with cognitive behavioral analysis system of psychotherapy: a systematic review and meta-analysis of randomized-controlled clinical trials. Brain and Behavior, 6, e00486.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta Earthquake. Journal of Personality and Social Psychology, 61, 115–121.CrossRefGoogle ScholarPubMed
Souery, D., Amsterdam, J., De Montigny, C., Lecrubier, Y., Montgomery, S., Lipp, O., … & Mendlewicz, J. (1999). Treatment resistant depression: methodological overview and operational criteria. European Neuropsychopharmacology, 9, 83–91.CrossRefGoogle ScholarPubMed
Trajković, G., Starčević, V., Latas, M., Leštarević, M., Ille, T., Bukumirić, Z., & Marinković, J. (2011). Reliability of the Hamilton Rating Scale for Depression: a meta-analysis over a period of 49 years. Psychiatry Research, 189, 1–9.CrossRefGoogle Scholar
Watkins, E. R. (2016). Rumination-Focused Cognitive-Behavioral Therapy for Depression. New York, NY: Guilford Press.Google Scholar
Watkins, E. R., Moberly, N. J., & Moulds, M. L. (2008). Processing mode causally influences emotional reactivity: distinct effects of abstract versus concrete construal on emotional response. Emotion, 8, 364–378.CrossRefGoogle ScholarPubMed
Watkins, E. R., Mullan, E., Wingrove, J., Rimes, K., Steiner, H., Bathurst, N., … & Scott, J. (2011). Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial. British Journal of Psychiatry, 199, 317–322.CrossRefGoogle ScholarPubMed
Watkins, E. R., & Nolen-Hoeksema, S. (2014). A habit-goal framework of depressive rumination. Journal of Abnormal Psychology, 123, 24.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.