2008 Abstracts

February 2008
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#1 Turkington, D., Sensky, T., Scott, J., Barnes, T. R. E., Nur, U., Siddle, R., Hammond, K., Samarasekara, N., & Kingdon, D. (2008). A randomized controlled trial of cognitive-behavior therapy for persistent symptoms in schizophrenia: A five-year follow-up. Schizophrenia Research, 98, 1-7.

Correspondence Address
Douglas Turkington: School of Neurology, Neurobiology and Psychiatry, Royal Victoria Infirmary, University of Newcastle, Leazes Wing, Richardson Road, Tyne and Wear, Newcastle upon Tyne, United Kingdom, NE1 4LP, douglas.turkington@ncl.ac.uk.

Abstract
Meta-analyses of randomized controlled trials support the efficacy of cognitive behavioral therapy (CBT) in the treatment of symptoms of schizophrenia refractory to antipsychotic medication. This article addresses the issue of medium term durability. A five-year follow-up was undertaken of a sample of 90 subjects who participated in a randomized controlled trial of CBT and befriending (BF). Patients received routine care throughout the trial and the follow-up period. Intention to treat multivariate analysis was performed by an independent statistician following multiple imputation of missing data. Fifty-nine out of ninety patients were followed up at 5 years (CBT = 31, BF = 28). In comparison to BF and usual treatment, CBT showed evidence of a significantly greater and more durable effect on overall symptom severity (NNT = 10.36, CI -10.21, 10.51) and level of negative symptoms (NNT = 5.22, CI -5.06 -5.37). No difference was found between CBT and BF on either overall symptoms of schizophrenia or depression. The initial cost of an adjunctive course of CBT for individuals with medication refractory schizophrenia may be justified in light of symptomatic benefits that persist over the medium term. (PsycINFO Database Record (c) 2008 APA, all rights reserved)



# 2 Bellino, S., Zizza, M., Rinaldi, C., & Bogetto, F. (2007). Combined therapy of major depression with concomitant borderline personality disorder: Comparison of interpersonal and cognitive psychotherapy. Canadian Journal of Psychiatry, 52, 718-725.

Correspondence Address
Silvio Bellino: Service for Personality Disorders, Unit of Psychiatry, Department of Neurosciences, University of Turin, Via Cherasco 11, Torino, Italy, 10126, silvio.bellino@unito.it.

Abstract
Objective: The combination of antidepressants and brief psychotherapies has been proven more efficacious in treating major depression and is particularly recommended in patients with concomitant personality disorders. We compare the effects of 2 combined therapies, fluoxetine and interpersonal therapy (IPT) or fluoxetine and cognitive therapy (CT), on major depression in patients with borderline personality disorder (BPD). Method: Thirty-five consecutive outpatients with a diagnosis of BPD and a major depressive episode (not bipolar and not psychotic) were enrolled. They were randomly assigned to 1 of the 2 combined treatments and treated for 24 weeks. Assessment included a semistructured interview, Clinical Global Impression (CGI) scale, Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HARS), Beck Depression Inventory-II (BDI-II), Social and Occupational Functioning Assessment Scale (SOFAS), Satisfaction Profile (SAT-P) for quality of life (QOL), and Inventory of Interpersonal Problems (IIP-64). Statistical analysis was performed using the univariate General Linear Model to calculate the effects of duration and type of treatment. Results: No significant differences between treatments were found at CGI, HDRS, BDI-II, and SOFAS score. Combined treatment with CT had greater effects on HARS score and on psychological functioning factor of SAT-P. Combined treatment with IPT was more effective on social functioning factor of SAT-P and on domains domineering or controlling and intrusive or needy of IIP-64. Conclusions: Both combined therapies are efficacious in treating major depression in patients with BPD. Differences between CT and IPT concern specific features of subjective QOL and interpersonal problems. These findings lack reliable comparisons and need to be replicated. (PsycINFO Database Record (c) 2007 APA, all rights reserved)

January 2008
Coelho, H. F., Canter, P. H., & Ernst, E. (2007). Mindfulness-based cognitive therapy: Evaluating current evidence and informing future research. Journal of Consulting and Clinical Psychology, 75, 1000-1005.

Correspondence Address:
Helen F. Coelho, Complementary Medicine, Universities of Exeter and Plymouth, 25, Victoria Park Road, Exeter EX2 4NT, UK
Tel.: + 44 1392 424942, Email: helen.coelho@pms.ac.uk

Abstract
Mindfulness-based cognitive therapy (MBCT) is a recently developed class-based program designed to prevent relapse or recurrence of major depression (Z. V. Segal, J. M. G. Williams, & J. Teasdale, 2002). Although research in this area is in its infancy, MBCT is generally discussed as a promising therapy in terms of clinical effectiveness. The aim of this review was to outline the evidence that contributes to this current viewpoint and to evaluate the strengths and weaknesses of this evidence to inform future research. By systematically searching 6 electronic databases and the reference lists of retrieved articles, the authors identified 4 relevant studies: 2 randomized clinical trials, 1 study based on a subset of 1 of these trials, and 1 nonrandomized trial. The authors evaluated these trials and discussed methodological issues in the context of future research. The current evidence from the randomized trials suggests that, for patients with 3 or more previous depressive episodes, MBCT has an additive benefit to usual care. However, because of the nature of the control groups, these findings cannot be attributed to MBCT-specific effects. Further research is necessary to clarify whether MBCT does have any specific effects. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract)