CBT for treatment resistant depression

摘要

In The Lancet, Nicola Wiles and colleagues answer the call for further study of the efficacy of psychotherapy for patients with treatment resistant depression. They recruited 469 patients (aged 18-75 years) with treatment-resistant depression from 73 UK general practices and randomly assigned them to one of two groups: usual care (n=235) or cognitive-behavioural therapy (CBT) in addition to usual care (n=234)- Patients were followed up for 12 months. Studies such as this one are much needed because an inadequate response to initial antidepressant treatment for depression is the most likely outcome in both general care and specialty clinics, with remission reported for only 35-40% of patients.3 Hence, Wiles and colleagues' trial1 provides a perspective on a non-pharmacological answer to the question facing most patients who have initiated treatment with an antidepressant: what should be regarded as an efficacious next-step strategy when non-response is confronted?