An Evaluation of Cognitive-Behaviour Therapy for Depression in Patients with Multiple Sclerosis

1984 ◽  
Vol 145 (4) ◽  
pp. 366-371 ◽  
Author(s):  
Nora A. Larcombe ◽  
Peter H. Wilson

SummaryTwenty depressed multiple sclerotic patients were randomly allocated either to cognitive-behaviour therapy or to a waiting list control condition. Assessment of depressive symptoms was conducted at pre-treatment, post-treatment, and a four-week follow-up. In comparison to the waiting list control condition, cognitive-behaviour therapy was found to result in clinically and statistically significant improvement on most measures. Although the mechanism by which such treatment achieves its effects is unclear, these results clearly support the use of cognitive-behavioural treatments for depression in this population.

2017 ◽  
Vol 51 (6) ◽  
pp. 565-582 ◽  
Author(s):  
Adrian L Lopresti

Objective: There is growing evidence confirming increased inflammation in a subset of adults with depression. The impact of this relationship has mostly been considered in biologically based interventions; however, it also has potential implications for psychological therapies. Cognitive behaviour therapy is the most commonly used psychological intervention for the treatment of depression with theories around its efficacy primarily based on psychological mechanisms. However, cognitive behaviour therapy may have an effect on, and its efficacy influenced by, physiological processes associated with depression. Accordingly, the purpose of this systematic review was to examine the relationship between cognitive behaviour therapy and inflammation. Method: Studies examining the anti-inflammatory effects of cognitive behaviour therapy in people with depression and other medical conditions (e.g. cancer, diabetes and heart disease) were examined. In addition, the relationship between change in inflammatory markers and change in depressive symptoms following cognitive behaviour therapy, and the influence of pre-treatment inflammation on cognitive behaviour therapy treatment response were reviewed. Results: A total of 23 studies investigating the anti-inflammatory effects of cognitive behaviour therapy were identified. In 14 of these studies, at least one reduction in an inflammatory marker was reported, increases were identified in three studies and no change was found in six studies. Three studies examined the relationship between change in inflammation and change in depressive symptoms following cognitive behaviour therapy. In two of these studies, change in depressive symptoms was associated with a change in at least one inflammatory marker. Finally, three studies examined the influence of pre-treatment inflammation on treatment outcome from cognitive behaviour therapy, and all indicated a poorer treatment response in people with higher premorbid inflammation. Conclusion: Preliminary evidence suggests inflammation should be considered within the context of cognitive behaviour therapy, although robust studies examining the relationship are sparse, and heterogeneity between studies and populations examined was high. The potential treatment implications of the bi-directional relationship between inflammation and cognitive behaviour therapy are discussed, and recommendations for future research are proposed.


2007 ◽  
Vol 41 (12) ◽  
pp. 990-997 ◽  
Author(s):  
Jules de Groot ◽  
Vanessa Cobham ◽  
Joyce Leong ◽  
Brett McDermott

Objective: The aim of the present study was to compare the relative effectiveness of group and individual formats of a family-focused cognitive–behavioural intervention, for the treatment of childhood anxiety disorders. Method: Twenty-nine clinically anxious children aged between 7 and 12 years were randomly allocated to either individual cognitive–behaviour therapy (ICBT) or group cognitive–behaviour therapy (GCBT). Results: At post-treatment assessment 57% of children in the ICBT condition no longer met criteria for any anxiety disorder, compared to 47% of children in the GCBT condition. At 3 month follow up these improvements were retained with some weakening. By the 6 month follow up 50% of children in the ICBT compared to 53% of children in the GCBT condition were anxiety diagnosis free. In terms of questionnaire data, no significant differences were detected between the ICBT and GCBT conditions at any of the follow-up points. However, a significant treatment effect for time was found, with both self-reports and parent reports indicating a significant reduction over time in anxiety symptoms. Conclusion: Overall, results suggest that children with anxiety disorders appear to improve following a family-focused cognitive behavioural intervention, regardless of individual or group administration. The interpretation and potential clinical implications of these findings are discussed, together with the limitations of this study and suggestions for future research.


2012 ◽  
Vol 40 (4) ◽  
pp. 452-461 ◽  
Author(s):  
Georgina Krebs ◽  
Cynthia Turner ◽  
Isobel Heyman ◽  
David Mataix-Cols

Background: Body dysmorphic disorder (BDD) is relatively common in adolescents and can have serious negative consequences. However, the treatment of BDD in young people has received virtually no empirical attention to date, and the evidence-base for cognitive behaviour therapy (CBT) in this population is limited to a small number of single case reports. Aims: This study aimed to investigate treatment outcomes associated with CBT, primarily consisting of exposure and response prevention, in a group of young people with BDD. Method: Six adolescents with a diagnosis of BDD received a course of developmentally appropriate CBT for BDD with parental involvement. BDD and depressive symptoms were evaluated at pre-treatment, post-treatment and at 3- or 6-month follow-up, using the Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS) and the Beck Depression Inventory-Youth, respectively. Results: Scores on the BDD-YBOCS indicated a 44% improvement in BDD symptoms at post-treatment and a 57% improvement at follow-up for the group. Considering response as a ≥30% reduction in BDD-YBOCS score, four of the six adolescents were classified as treatment responders. Improvements in depressive symptoms were observed among the treatment responders, but not the non-responders. Conclusions: These findings indicate the potential efficacy of CBT, including exposure and response prevention for adolescents with BDD, and highlight the need for further controlled trials.


2001 ◽  
Vol 70 (6) ◽  
pp. 298-306 ◽  
Author(s):  
Valdo Ricca ◽  
Edoardo Mannucci ◽  
Barbara Mezzani ◽  
Sandra Moretti ◽  
Milena Di Bernardo ◽  
...  

2016 ◽  
Vol 44 (6) ◽  
pp. 673-690 ◽  
Author(s):  
Philip Andersen ◽  
Paul Toner ◽  
Martin Bland ◽  
Dean McMillan

Background: Transdiagnostic Cognitive Behaviour Therapy (CBT) seeks to identify core cognitive-behavioural processes hypothesized to be important across a range of disorders and to develop a treatment that targets these. This contrasts with standard CBT approaches that are disorder-specific. Proponents of transdiagnostic CBT suggest that it may offer advantages over disorder-specific CBT, but little is known about the effectiveness of this approach. Aims: The review aimed to summarize trial-based clinical and cost-effectiveness data on transdiagnostic CBT for anxiety and depression. Method: A systematic review of electronic databases, including peer-reviewed and grey literature sources, was conducted (n = 1167 unique citations). Results: Eight trials were eligible for inclusion in the review. There was evidence of an effect for transdiagnostic CBT when compared to a control condition. There were no differences between transdiagnostic CBT and active treatments in two studies. We found no evidence of cost-effectiveness data. Conclusions: Quality assessment of the primary studies indicated a number of methodological concerns that may serve to inflate the observed effects of transdiagnostic approaches. Although there are positive signs of the value of transdiagnostic CBT, there is as yet insufficient evidence to recommend its use in place of disorder-specific CBT.


Author(s):  
Zafra Cooper ◽  
Rebecca Murphy ◽  
Christopher G. Fairburn

The eating disorders provide one of the strongest indications for cognitive behaviour therapy. This bold claim arises from the demonstrated effectiveness of cognitive behaviour therapy in the treatment of bulimia nervosa and the widespread acceptance that cognitive behaviour therapy is the treatment of choice. Cognitive behaviour therapy is also widely used to treat anorexia nervosa although this application has not been adequately evaluated. Recently its use has been extended to ‘eating disorder not otherwise specified’ (eating disorder NOS), a diagnosis that applies to over 50 per cent of cases, and emerging evidence suggests that it is just as effective with these cases as it is with cases of bulimia nervosa. In this chapter the cognitive behavioural approach to the understanding and treatment of eating disorders will be described. The data on the efficacy and effectiveness of the treatment are considered in the chapters on anorexia nervosa and bulimia nervosa (see Chapters 4.10.1 and 4.10.2 respectively), as is their general management.


Author(s):  
Amita Jassi ◽  
Lorena Fernández de la Cruz ◽  
Ailsa Russell ◽  
Georgina Krebs

Abstract Obsessive–compulsive disorder (OCD) and autism spectrum disorder (ASD) frequently co-occur. Standard cognitive behaviour therapy (CBT) for OCD outcomes are poorer in young people with ASD, compared to those without. The aim of this naturalistic study was to evaluate the effectiveness of a novel adolescent autism-adapted CBT manual for OCD in a specialist clinical setting. Additionally, we examined whether treatment gains were maintained at 3-month follow-up. Thirty-four adolescents underwent CBT; at the end of treatment, 51.51% were treatment responders and 21.21% were in remission. At 3-month follow-up, 52.94% were responders and 35.29% remitters. Significant improvements were also observed on a range of secondary measures, including family accommodation and global functioning. This study indicates this adapted package of CBT is associated with significant improvements in OCD outcomes, with superior outcomes to those reported in previous studies. Further investigation of the generalizability of these results, as well as dissemination to different settings, is warranted.


2014 ◽  
Vol 40 (2) ◽  
Author(s):  
Kim Minjoo ◽  
Elias Mpofu ◽  
Kaye Brock ◽  
Michael Millington ◽  
James Athanasou

Orientation: To identify the effects of interventions in cognitive-behaviour therapy (CBT) on employment-related outcomes world-wide for individuals with mental illness.Research purpose: A search of the relevant literature was conducted through PsychInfo, Medline, Scopus and Google Scholar™, covering the period between 1995 and August 2011. The methodological quality of included studies was assessed using the criteria from Evidence Based Library and Information Practice (EBLIP). Eleven studies met the inclusion criteria.Motivation for the study: Evidence is needed on best practices to support work participation by people with mental illness. Effective cognitive-behavioural intervention might enhance their personal control over participation in employment aside from systemic or policy-oriented interventions.Research approach, design and method: A scoping review was done to map trends in the evidence for CBT as an intervention to support employment participation by people with mental illness. A scoping review is exploratory, the evidence of which lays the basis for subsequent studies. The methodological quality of included studies was assessed using the EBLIP Critical Appraisal Checklist.Main findings: Cognitive-behaviour therapy was an effective intervention approach for better work productivity, longer work hours, higher re-employment rate and enhanced mental health for individuals with mental illness.Practical/managerial implications: Cognitive-behaviour therapy is a promising strategy for industrial and organisational psychologists dealing with people who have a mental illness. It enhances employment and maintains work adjustment. Additional clinical trials in diverse populations and contexts will further establish its efficacy.Contribution/value-add: This scoping review aggregated the preliminary evidence for the efficacy of cognitive-behaviour therapy as a work-participation intervention for people with mental illness.


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