Reduced attrition; but patients who undergo face-to-face therapy are less depressed at six months
TUESDAY, June 5 (HealthDay News) -- Telephone-administered cognitive behavioral therapy (T-CBT) correlates with reduced attrition and similar post-treatment improvement in depression compared to face-to-face CBT, but at six months, those who undergo face-to-face CBT are significantly less depressed, according to a study published in the June 6 issue of the Journal of the American Medical Association.
David C. Mohr, Ph.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues randomized 325 patients with major depressive disorder to receive 18 sessions of either telephone-administered or face-to-face CBT. Outcomes measured included attrition; interviewer-rated depression, assessed using the Hamilton Depression Rating Scale (Ham-D); and self-reported depression, measured with the Patient Health Questionnaire-9 (PHQ-9).
The researchers found that significantly fewer participants discontinued T-CBT compared to face-to-face CBT (20.9 versus 32.7 percent). Patients in both groups showed significant improvement in depression, with no significant treatment differences at post-treatment on the Ham-D or the PHQ-9. The intention-to-treat post-treatment effect size on both the Ham-D (d = 0.14) and the PHQ-9 (d = −0.02) were within the inferiority margin of d = 0.41, indicating that T-CBT was not inferior to face-to-face CBT. At the six-month follow-up, all participants remained significantly less depressed relative to baseline, but on the Ham-D and the PHQ-9, participants receiving face-to-face CBT were significantly less depressed than those receiving T-CBT.
"Our findings demonstrate that T-CBT can reduce attrition and is as effective as face-to-face CBT at post-treatment for depression among primary care patients," the authors write. "However, the increased adherence associated with T-CBT may come at the cost of some increased risk of poorer outcomes after treatment cessation."