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Group rumination-focused cognitive-behavioural therapy (CBT) v. group CBT for depression: phase II trial

Published online by Cambridge University Press:  11 January 2019

Morten Hvenegaard ,
Stine B. Moeller ,
Stig Poulsen ,
Matthias Gondan ,
Ben Grafton ,
Stephen F. Austin ,
Morten Kistrup ,
Nicole G. K. Rosenberg ,
Henriette Howard  and
Edward R. Watkins
Morten Hvenegaard*
Affiliation:
Department of Psychology, University of Copenhagen, Copenhagen, Denmark
Stine B. Moeller
Affiliation:
Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark
Stig Poulsen
Affiliation:
Department of Psychology, University of Copenhagen, Copenhagen, Denmark
Matthias Gondan
Affiliation:
Department of Psychology, University of Copenhagen, Copenhagen, Denmark
Ben Grafton
Affiliation:
Cognition and Emotion Lab, School of Psychology, University of Western Australia, Crawley, Australia
Stephen F. Austin
Affiliation:
Psychiatric Research Unit, Mental Health Centre North Zealand, University of Copenhagen, Hillerød, Denmark
Morten Kistrup
Affiliation:
Psychiatric Outpatient Service, Mental Health Centre North Zealand, Hillerød, Denmark
Nicole G. K. Rosenberg
Affiliation:
Psychotherapeutic Clinic Nannasgade, Mental Health Centre Copenhagen, Capital Region Mental Health Services, Copenhagen, Denmark
Henriette Howard
Affiliation:
Mental Health Centre for Child and Adolescent Psychiatry, Glostrup, Denmark
Edward R. Watkins
Affiliation:
Mood Disorders Centre, School of Psychology, University of Exeter, Exeter, UK
*
Author for correspondence: Morten Hvenegaard, E-mail: morten.hvenegaard@psy.ku.dk
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Abstract

Background

Although cognitive-behavioural therapy (CBT) is an effective treatment for depression, less than half of patients achieve satisfactory symptom reduction during treatment. Targeting known psychopathological processes such as rumination may increase treatment efficacy. The aim of this study was to test whether adding group rumination-focused CBT (RFCBT) that explicitly targets rumination to routine medical management is superior to adding group CBT to routine medical management in treating major depression.

Methods

A total of 131 outpatients with major depression were randomly allocated to 12 sessions group RFCBT v. group CBT, each in addition to routine medical management. The primary outcome was observer-rated symptoms of depression at the end of treatment measured on the Hamilton Rating Scale for Depression. Secondary outcomes were rumination at post-treatment and depressive symptoms at 6 months follow-up (Trial registered: NCT02278224).

Results

RFCBT significantly improved observer-rated depressive symptoms (Cohen's d 0.38; 95% CI 0.03–0.73) relative to group CBT at post-treatment on the primary outcome. No post-treatment differences were found in rumination or in depressive symptoms at 6 months follow-up, although these secondary analyses may have been underpowered.

Conclusions

This is the first randomized controlled trial providing evidence of benefits of RFCBT in major depression compared with CBT. Group RFCBT may be a beneficial alternative to group CBT for major depression.

Keywords

Cognitive-behavioural therapydepressionRCTrumination-focused CBTrumination
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 1 , January 2020 , pp. 11 - 19
Copyright
Copyright © Cambridge University Press 2019 

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