Group Cognitive Behaviour Therapy for Residual Depression: Effectiveness and Predictors of Response

To date, there is a lack of evidence on the effectiveness of cognitive behaviour therapy for residual depression in naturalistic treatment settings. Previous reports have indicated that perfectionism and self-criticism may be predictive of poor response to individual cognitive behaviour therapy for acute depression. However, no studies of the impact of these cognitive variables on the outcome of treatment for residual depression have been reported. Accordingly, we sought to evaluate the effectiveness of a group cognitive behaviour therapy program for residual depression and to assess the impact of self-criticism, self-oriented perfectionism and socially prescribed perfectionism on the outcome of this treatment. Sixty-five patients (44 women) with residual symptoms (Beck Depression Inventory score >8) following medication treatment for major depression completed measures of depression, functional status, self-criticism, self-oriented perfectionism and socially prescribed perfectionism before and after 12 sessions of group cognitive behaviour therapy. Depression symptoms and functional status both showed significant change over the course of treatment (Cohen's d = 0.62 and 0.39, respectively). Pre-treatment self-criticism scores and change scores (pre- to post-treatment) for self-criticism and socially prescribed perfectionism were associated with the symptomatic and functional outcome of treatment. The results suggest that group cognitive behaviour therapy may be a useful and cost-effective treatment for residual depression in a tertiary care setting that uses predominantly prescriptive treatment.

Keywords:

• Cognitive
• Behaviour
• Therapy
• Depression
• Group
• Therapy
• Outcome
• Perfectionism
• Residual
• Symptoms
• Self-CRITICISM