Clinical relevance of findings in trials of CBT for depression
Open accessAbstract
Cognitive behavioural therapy (CBT) is beneficial in depression. Symptom scores can be translated into Clinical Global Impression (CGI) scale scores to indicate clinical relevance. We aimed to assess the clinical relevance of findings of randomised controlled trials (RCTs) of CBT in depression. We identified RCTs of CBT that used the Hamilton Rating Scale for Depression (HAMD). HAMD scores were translated into Clinical Global Impression – Change scale (CGI-I) scores to measure clinical relevance. One hundred and seventy datasets from 82 studies were included. The mean percentage HAMD change for treatment arms was 53.66%, and 29.81% for control arms, a statistically significant difference. Combined active therapies showed the biggest improvement on CGI-I score, followed by CBT alone. All active treatments had better than expected HAMD percentage reduction and CGI-I scores. CBT has a clinically relevant effect in depression, with a notional CGI-I score of 2.2, indicating a significant clinical response. The non-specific or placebo effect of being in a psychotherapy trial was a 29% reduction of HAMD.
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CBT, ACT, and MBSR are effective treatments for chronic pain and for depression, anxiety, and other mental health conditions prevalent in US veterans.
“Cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), and mindfulness-based stress reduction (MBSR) are effective for chronic pain and several mental health conditions.”
From Evaluation of Implementation Strategies for Cognitive Behavioral Therapy (CBT), Acceptance and Commitment Therapy (ACT), and Mindfulness-Based Stress Reduction (MBSR): a Systematic Review (2023) · cites this paper as [5]
The Discussion reports a clinically relevant effect of CBT for depression. The paper does not establish that ACT or MBSR is effective, or that any of the therapies is effective for chronic pain, anxiety, or other conditions in US veterans. (LLM, conf=0.90)
Experimental — accuracy not yet measuredIn-person psychosocial interventions, particularly CBT-based interventions, can be effective in helping decrease symptoms of depression, and this is also the case for CBT- and ACT-based interventions for people living with chronic pain.
“In-person psychosocial interventions, particularly CBT-based interventions, can be effective in helping decrease the symptoms of depression [59], and this is also the case for CBT- and ACT-based interventions for people living with chronic pain [8,13].”
From Short-Term Findings From Testing EPIO, a Digital Self-Management Program for People Living With Chronic Pain: Randomized Controlled Trial (2023) · cites this paper as [59]
The Discussion reports that CBT produced a clinically relevant improvement in depression symptoms and outperformed control conditions. The Methods do not specify that the interventions were delivered in person, so that qualifier is not established by this source. The chronic-pain claim is attached to other citations, not this one. (LLM, conf=0.82)
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References 19 · Cited by 60
- Authors
- Lepping, P., Whittington, R., Sambhi, R. S., Lane, S., Poole, R., Leucht, S., Cuijpers, P., McCabe, R., & Waheed, W.
- Affiliations
- Betsi Cadwaladr University Health Board (GB)
- University of Liverpool (GB)
- Technical University of Munich (DE)
- Amsterdam Public Health (NL)
- Mersey Care NHS Trust (GB)
- University of Manchester (GB)
- Corresponding author
- Lepping, P.
- Venue
- European Psychiatry
- Publisher
- Cambridge University Press (CUP)
- Published
- 2017-09
- Volume
- 45
- Pages
- 207-211
- ISSN
- 0924-9338 (ISSN-L)
- 1778-3585
- OpenAlex
- W2739098172
- Cited by
- 60
- References
- 19
- Citations by year
- 2026: 6 · 2025: 7 · 2024: 9 · 2023: 9 · 2022: 6 · 2021: 8 · 2020: 7 · 2019: 6 · 2018: 1 · 2017: 1
- FWCI
- 5.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (publishedVersion)
- mediaTUM (Technical University of Munich) (submittedVersion)
- Bangor University Research Portal (Bangor University) (submittedVersion, other-oa)
- VU Research Portal (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- cognitive behavioral therapy, depression, clinical relevance, Hamilton Depression Rating Scale, Clinical Global Impression Scale, CGI-I, treatment effect size, placebo effect
- MeSH terms
- Depression, Depressive Disorder, Female, Humans, Male, Psychotherapy, Psychotherapy, Brief, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome
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