Cognitive Behavioural Analysis System of Psychotherapy (CBASP) for chronic depression: Clinical characteristics and six month clinical outcomes in an open case series.

Background: Evidence-based guidance on how best to treat chronic depression is limited. Cognitive Behavioural Analysis System of Psychotherapy (CBASP) has shown some promise with this 'difficult-to-treat' clinical group. This case series was designed to assess the acceptability and utility of this novel treatment in routine clinical practice within the U.K. National Health Service. Methods: We offered an open trial of CBASP to a cohort of 115 referred patients within primary and secondary care. Diagnostic interview and standardised outcome measures were administered before and after 6 months of CBASP with a trained, accredited therapist. Results: Seventy-four patients entered therapy, with 46 completing. 30% met criteria for remission (<= 8 HRSD-24 score) and a further 30% met criteria for clinically significant change (> 8 and <= 15 HRSD-24 plus 50% reduction in baseline score). Thirty-nine per cent made "No change". Group measures of quality of life, social functioning and interpersonal functioning also improved. Limitations: This was an open study design with a moderate sample size and no control group. Ratings were not completed using a blinded procedure. Conclusions: CBASP is an acceptable therapy for a large proportion of patients with chronic depression and was associated with clinically significant change in 60% of completers. Crown Copyright (C) 2013 Published by Elsevier B.V. All rights reserved.