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

Edward R. Watkins*, Eugene Mullan, Janet Wingrove, Katharine Rimes, Herbert Steiner, Neil Bathurst, Rachel Eastman, Jan Scott

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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. Declaration of interest: None.

Original languageEnglish
Pages (from-to)317-322
Number of pages6
JournalBritish Journal of Psychiatry
Volume199
Issue number4
DOIs
Publication statusPublished - Oct 2011
Externally publishedYes

ASJC Scopus subject areas

  • Psychiatry and Mental Health

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