Nurse-led group cognitive behavioral therapy for major depressive disorder among adults in Japan: A preliminary single-group study.
Hiroki Tanoue, Naoki Yoshinaga, Sayaka Kato and 3 others
PMID 31406828WHAT IT FOUND
In 23 Japanese adults with depression, nurse-led group cognitive behavioral therapy over six weeks was associated with lower depression scores, from 23.1 to 12.4, while antidepressant or anxiolytic medication continued.
No control group means this cannot show therapy alone caused change.
Key findings
01The primary depression score improved from 23.1 to 12.4 in the intention-to-treat sample, with an effect size of 1.33.
02The study analysed 23 patients; 20 completed the program, which consisted of six 90-minute weekly group cognitive behavioral therapy sessions, and no serious adverse events were reported.
03Participants could continue antidepressant or anxiolytic medication, and the study had no control group, so the improvement cannot be separated from medication or time.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
There was no control group, so the study cannot show that nurse-led group CBT caused the improvement. The sample was small, with 23 patients analysed, which limits confidence in the results. Patients could continue antidepressant or anxiolytic medication, so the contribution of CBT alone cannot be separated from medication. The therapists were nurses who knew some participants, which may have affected dropout. There was no long-term follow-up, so the results do not show whether benefits persisted. The sample was younger and had fewer married or employed patients than previous Japanese surveys, so it may not represent typical patients. Patient views about the program were not collected.
Declared interests
Funding was provided by Grants-in-Aid for Scientific Research (KAKENHI) from the Japan Society for the Promotion of Science, grant number 25463556 to YS. No other conflict-of-interest statement is given in the supplied text.
The easy way to misread this
Do not conclude that nurse-led group cognitive behavioral therapy causes improvement in depression. The study had no control group, and patients could continue antidepressant or anxiolytic medication, so the change cannot be separated from time, expectation, or medication.