CBT of limited value for teen depressives

The value of cognitive behavioural therapy (CBT) for depression may have been 'over blown', claims a UK psychiatrist.

CBT of limited value for teen depressives
CBT of limited value for teen depressives

A study of over 208 adolescents aged 11-17 with moderate to severe depression showed that there was little difference in outcome between those given antidepressants and routine care and patients also given CBT.

All received fluoxetine, at an average dose of 30mg daily, or another SSRI and routine care, with 105 also receiving a course of CBT for 12 weeks.

Both groups showed a similar degree of improvement on the Health of the Nation outcome scales for children and adolescents after 12 weeks.

There was a decrease in self-harm, but CBT was not found to have a protective effect against suicidal ideation.

Lead researcher Professor Ian Goodyer, a child and adolescent psychiatrist at Cambridge University, said: 'The evidence that CBT is effective in moderate to severe depression is over blown.'

The findings bring into question NICE advice that first-line treatment of children and young people with moderate to severe depression should be psychological therapies such as CBT.

'It does not square with the guideline advice. NICE might want to reconsider its position,' said Professor Goodyer.

Dr Chris Manning, chief executive of Primary Care Mental Health and Education, said CBT was 'not the only fruit' in the range of treatments for depression.

'It's being over blown because we've got to get an effective psychological therapy out there,' said Dr Manning.

CBT is the easiest therapy to provide quantifiable data for, he explained: 'We need to have a range of interventions.'

A NICE spokeswoman said the guidelines for the management of depression in children and young people will be reviewed in 2009.

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