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8 - Depression

Published online by Cambridge University Press:  01 January 2018

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Summary

Overview

This chapter will examine the theories of depression. It will start by looking at NICE guidance and present some of the interventions for differing degrees of depression. There will be a discussion of some of the early behavioural interventions and their current role in therapy. Beck's cognitive theory of depression will then be discussed. Case examples will be used to demonstrate behavioural activation and activity scheduling as well as cognitive reattribution. There will be a full description of third generation therapies, which may have a role in the treatment of depression, including case examples illustrating mindfulness and acceptance and commitment therapy. The use of CBT and guided mourning for patients experiencing morbid grief will also be demonstrated.

Depression is an extremely common and disabling problem throughout the world. Indeed, depression is ranked as one of the most frequent causes of disability in the world (World Health Organization, 2001).

Based on figures released by NICE, depression accounts for a third of all consultations with the GP in the UK (http://cks.nice.org.uk/ depression#!backgroundsub:1). Each year 5% of adults experience an episode of clinical depression. Episodes of depression serious enough to warrant treatment occur in a quarter of women and 10% of men throughout their lives. Prevalence rates of depression are consistently between 1.5 to 2.5 times higher in women than in men.

Depression was the subject of NICE guidance in 2009. In surveys of patients in the UK, patients prefer to receive CBT than medication wherever possible. It has been shown that CBT is as effective as medication in mild, moderate and severe depression. In the more severe forms of depression, combination of drug therapy and CBT seems to improve outcome.

An important aspect of treating depression is to measure the efficacy of any intervention. One way of doing this is to use a self-completion questionnaire such as the BDI (Beck, 1978).

Type
Chapter
Information
CBT for Adults
A Practical Guide for Clinicians
, pp. 113 - 134
Publisher: Royal College of Psychiatrists
Print publication year: 2014

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