Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-25T05:43:30.071Z Has data issue: false hasContentIssue false

The Nottingham Study of Neurotic Disorder: Influence of Cognitive Therapists on Outcome

Published online by Cambridge University Press:  02 January 2018

David Kingdon*
Affiliation:
Bassetlaw District General Hospital
Peter Tyrer
Affiliation:
St Charles Hospital, London W10
Nicholas Seivewright
Affiliation:
Sheffield
Brian Ferguson
Affiliation:
Mapperley Hospital, Nottingham
Siobhan Murphy
Affiliation:
St Bartholomew's Hospital, London
*
Dr D. Kingdon, Department of Psychiatry, Bassetlaw District General Hospital, Worksop, Nottingham S81 0BD

Abstract

Background

In previously published papers from the Nottingham Study of Neurotic Disorder a short treatment package of cognitive–behaviour therapy was no more effective than placebo drug treatment after 10 weeks' assessment in a cohort of 210 patients with neurotic disorders. This paper examines the outcome over two years of the patients treated by cognitive–behaviour therapy separated into two therapist groups, those who were competent in administering treatment and those of uncertain competence.

Method

The therapists (mainly community psychiatric nurses) of 70 patients with an original DSM–III diagnosis of either dysthymic, panic or generalised anxiety disorder were separated into two groups on the basis of their perceived competence by their supervisor (DK). Ratings of psychopathology were made at regular intervals over two years by assessors blind to knowledge of treatment or therapist.

Results

The patients treated by competent therapists (n=30) generally showed greater improvement than those allocated to therapists of uncertain competence (n=40), mainly with respect to depressive symptoms, and the difference persisted over two years, long after the cognitive–behaviour therapy had been completed.

Conclusions

Cognitive–behaviour therapy given by competent therapists over a 10 week period is of lasting benefit in neurotic disorder.

Type
Papers
Copyright
Copyright © 1996 The Royal College of Psychiatrists 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Åsberg, M., Montgomery, S. A., Perris, C., et al (1978) A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica (Suppl. 271) 5 29.CrossRefGoogle Scholar
Backham, E. E. & Watkins, J. T. (1989) Process and outcome in cognitive therapy. In Comprehensive Handbook of Cognitive Therapy (eds Freeman, H., Simon, K. M., Butler, L. E., et al). New York: Plenum Press.Google Scholar
Beck, A. T., Emery, G. & Greenberg, R. L. (1985) Anxiety Disorders and Phobias: a Cognitive Perspective. New York Basic Books.Google Scholar
Durham, R. C., Murphy, T., Allan, T., et al (1994) Cognitive therapy, analytic psychotherapy and anxiety management training for generalised anxiety disorder. British Journal of Psychiatry, 165, 315323.Google Scholar
Montgomery, S. A. & Åsberg, M. (1979) A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382389.Google Scholar
Tyrer, P., Owen, R. T. & Cicchetti, D. (1984) The Brief Scale for Anxiety: a subdivision of the Comprehensive Psychopathological Rating Scale. Journal of Neurology, Neurosurgery and Psychiatry, 47, 970975.CrossRefGoogle ScholarPubMed
Tyrer, P., Seivewright, N., Murphy, S., et al (1988) The Nottingham study of neurotic disorder comparison of drug and psychological treatments. Lancet, ii, 235240.Google Scholar
Tyrer, P., Seivewright, N., Ferguson, B., et al (1993) The Nottingham study of neurotic disorder effect of personality status on response to drug treatment, cognitive therapy and self-help over two years. British Journal of Psychiatry, 162, 219226.CrossRefGoogle ScholarPubMed
Vallis, M.T., Shaw, B. F. & Dobson, K. S. (1986) The cognitive therapy scale: psychometric properties. Journal of Consulting and Clinical Psychology, 54, 381385.CrossRefGoogle ScholarPubMed
Zigmond, A. S. & Snaith, R. P. (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 57, 361370.CrossRefGoogle Scholar
Submit a response

eLetters

No eLetters have been published for this article.