Effects of cognitive therapy on psychological symptoms and social functioning in residual depression

Background About 30% of psychiatric out-patients with major depression demonstrate partial remission. Aims To explore whether the addition of cognitive therapy (CT) had any differential effect on residual symptoms or social adjustment. Method Patients with residual symptoms of major depression (n=158) were randomised to receive clinical management (CM) alone, or CM plus 18 sessions of CT. Subjects' depressive symptoms and social functioning were assessed regularly over 16 months. Results The addition of CT produced statistically significant differential effects on: two out of four measures of overall severity of depression; specific psychological symptoms (guilt, self-esteem and hopelessness); and social functioning (including dependency, interpersonal behaviour and friction). Conclusions In patients showing only partial response to antidepressants, the addition of CT produced modest improvements in social and psychological functioning. The implications for research on the mechanisms of action of CTare discussed. Declaration of interest Supported by grants from the Medical Research Council and an additional grant from the Oxford and Anglia Region.