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Efficacy of trial-based cognitive therapy, behavioral activation and treatment as usual in the treatment of major depressive disorder: preliminary findings from a randomized clinical trial

Published online by Cambridge University Press:  26 November 2019

Curt Hemanny Open the ORCID record for Curt Hemanny [Opens in a new window] ,
Clara Carvalho ,
Nina Maia ,
Daniela Reis ,
Ana Cristina Botelho ,
Dagoberto Bonavides ,
Camila Seixas  and
Irismar Reis de Oliveira
Curt Hemanny*
Affiliation:
Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Brazil
Clara Carvalho
Affiliation:
Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Brazil
Nina Maia
Affiliation:
Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Brazil
Daniela Reis
Affiliation:
Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Brazil
Ana Cristina Botelho
Affiliation:
Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Brazil
Dagoberto Bonavides
Affiliation:
Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Brazil
Camila Seixas
Affiliation:
Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Brazil
Irismar Reis de Oliveira*
Affiliation:
Postgraduate Program of Interactive Processes of Organs and Systems, Health Sciences Institute, Federal University of Bahia, Brazil Department of Neurosciences and Mental Health, Postgraduate Program in Medicine and Health, Federal University of Bahia, Brazil.
*
*Curt Hemanny, Email: [email protected]
†Curt Hemanny and Irismar Reis de Oliveira contributed equally to this work.
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Abstract

Introduction.

Major depressive disorder (MDD) is a prevalent, debilitating and disabling disorder, and its prevalence is increasing. Antidepressants (AD), cognitive-behavioral therapy (CBT) and behavioral activation (BA) are the main treatments for MDD. Trial-based cognitive therapy (TBCT) addresses and restructures dysfunctional negative core beliefs (CBs) and is a novel and promising approach.

Objective.

The aim of this study was to compare the efficacy of TBCT, BA and treatment as usual (TAU) in the treatment of MDD.

Methods.

A total of 76 patients with MDD were randomized into 1 of 3 groups and evaluated at baseline, after 6 weeks and at week 12 (final evaluation). The primary outcome was changing in HAM-D scores, and the secondary outcomes included scores on the BDI, CD-Quest, Sheehan Disability Scale (SDS) and WHOQOL.

Results.

Both TBCT and BA (which also included AD) were different from TAU (which included antidepressants alone) in reducing the HAM-D and BDI scores and other measures. TBCT and BA were different from TAU in the reduction of disability in SDS and WHOQOL physical domain scores. Besides limited by a small sample size, the dropout rate in the TAU arm was higher, and only 10 patients completed the 3 evaluations.

Conclusion.

This trial provides evidence that TBCT and BA combined with antidepressants were more efficacious than the TAU (drug alone) in reducing the severity of depressive symptoms and disability, showing that this combination can be useful for clinical practice.

Keywords

Behavioral activationtrial-based cognitive therapymajor depressive disorderclinical trialtreatment as usual.
Type
Original Research
Information
CNS Spectrums , Volume 25 , Issue 4 , August 2020 , pp. 535 - 544
Copyright
© Cambridge University Press 2019

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