talking therapiesPeople with depression who show a preference for talking therapies are likely to get as much benefit from their treatment whether they are mildly, moderately or severely ill, a study has found.

A global team of researchers analysed data from 509 patients who took part in 5 clinical trials of cognitive behavioural therapy (CBT) for depression. They found that patients who were severely depressed responded just as well to talking therapies as those with mild or moderate depression. 

The research was led by Toshi Furukawa and Shiro Tanaka from Kyoto University Graduate School of Medicine/Public Mental Health, Japan, and Erika Weitz from VU University Amsterdam. It builds on evidence that co-author Pim Cuijpers’ team from VU University Amsterdam is establishing.

The researchers found: “Psychotherapies have traditionally been believed to be better suited for treating people with mild depression. But patients and their clinicians can expect as much benefit from CBT for major depression across its wide range of baseline severity from mild through severe.”

Traditionally, severely depressed people are offered medication as CBT is not thought to be effective in the first instance. But this study suggested that was not the case. It concluded that differences in efficacy between medication and CBT across the range of severity were “small enough to allow value judgements and preferences of individual patients to play a major role in treatment decision-making.”

Dr Cosmo Hallstrom, from the Royal College of Psychiatrists, said: “Treatments are known to be more effective if they fit in with the patients’ personal preference. It is important to have a range of therapeutic options available for this serious condition so that patients can be offered treatment that are not only of benefit, but are acceptable to the patient.”