Journal
JOURNAL OF AFFECTIVE DISORDERS
Volume 294, Issue -, Pages 745-752Publisher
ELSEVIER
DOI: 10.1016/j.jad.2021.07.061
Keywords
Depression; Naturalistic; CBT; cognitive behavior therapy; Treatment
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The study examined the effectiveness of CBT for depression in primary care, finding significant reductions in depression and anxiety symptoms in participants who engaged in CBT. However, the study has multiple limitations, including its naturalistic study design and symptomatic measurement.
Background: Individuals with depressive disorders often present to and seek treatment in primary care. Integrated behavioral health services within this setting can improve access to evidence-based cognitive behavioral therapy (CBT). However, limited information exists on the effectiveness of CBT for depression in primary care. Methods: Of the 1,302 participants with a primary depressive disorder referred by their primary care provider, 435 endorsed moderate to severe depression at baseline and engaged in at least one CBT session. A psychotherapy tracking database was used to collect relevant data, which included demographics, clinical characteristics, treatment outcomes, and CBT intervention use. Results: Participants with moderate to severe depression who participated in CBT reported a significant decrease in depression and anxiety symptoms at the end of treatment (p <= .001, d = 0.52-0.78). Rates of reliable change, response, and remission and types of CBT interventions used differed between major and persistent depressive disorders. Limitations: Multiple limitations must be noted, which are related to the naturalistic study design, inclusion and exclusion criteria, sample operationalization, symptomatic measurement, time-limited and focused assessment, data collection strategies, and psychological services. Together, these temper the conclusions that can be drawn. Conclusion: Significant reductions in depression and anxiety symptoms were reported by participants with depressive disorders who engaged in short-term CBT within primary care. This study indicates that CBT can be implemented within primary care and suggests that primary care patients with depression can benefit from integrated psychological services, supporting population-based models of care.
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