Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial

E R Watkins, E Mullan, J Wingrove, Katharine Rimes, H Steiner, N Bathurst, R Eastman, J Scott

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164 Citations (Scopus)

Abstract

Background: About 20% of major depressive episodes become chronic and medication-refractory and also appear to be less responsive to standard cognitive-behavioural therapy (CBT).

Aims: To test whether CBT developed from behavioural activation principles that explicitly and exclusively targets depressive rumination enhances treatment as usual (TAU) in reducing residual depression.

Method: Forty-two consecutively recruited participants meeting criteria for medication-refractory residual depression were randomly allocated to TAU v. TAU plus up to 12 sessions of individual rumination-focused CBT. The trial has been registered (ISRCTN22782150).

Results: Adding rumination-focused CBT to TAU significantly improved residual symptoms and remission rates. Treatment effects were mediated by change in rumination.

Conclusions: This is the first randomised controlled trial providing evidence of benefits of rumination-focused CBT in persistent depression. Although suggesting the internal validity of rumination-focused CBT for residual depression, the trial lacked an attentional control group so cannot test whether the effects were as a result of the specific content of rumination-focused CBT v. non-specific therapy effects.

Original languageEnglish
Pages (from-to)317-322
Number of pages6
JournalThe British Journal of Psychiatry
Volume199
Issue number4
Early online date20 Jul 2011
DOIs
Publication statusPublished - Oct 2011

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    Watkins, E. R., Mullan, E., Wingrove, J., Rimes, K., Steiner, H., Bathurst, N., Eastman, R., & Scott, J. (2011). Rumination-focused cognitive-behavioural therapy for residual depression: phase II randomised controlled trial. The British Journal of Psychiatry, 199(4), 317-322. https://doi.org/10.1192/bjp.bp.110.090282