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Depression subtypes linked to varying effectiveness of CBT

Mental Health Today News

https://www.mentalhealthtoday.co.uk

“Correspondingly, aiming to improve clinical outcomes, researchers at the University of Sheffield and leso Digital Health have analysed the type and severity of symptoms of more than 8,000 patients and have found that five distinct subtypes respond differently to treatment by Cognitive Behavioural Therapy (CBT).

The five broad subtypes of depression identified in the study were:

  • Mild: Minimal symptoms, a state of mild overall severity of depression (2.7% of patients).
  • Severe: A serious state of depression, people typically experience all symptoms at a very elevated level (9.8% of patients).
  • Cognitive-affective: Intense feelings of depression, tiredness and low self-esteem. People may have repetitive negative thoughts and struggle to feel pleasure in activities they usually enjoy and lack motivation (23.7% of patients).
  • Somatic: Difficulties sleeping, feeling of tiredness and changes in appetite, as well as psychomotor disturbances such as restlessness, fidgeting and pacing (21.4% of patients).
  • Typical: Patients experience a combination of both cognitive-affective and somatic symptoms to varying degrees of severity (42.4% of patients).

Analysis of patients and their subtype response to CBT treatment revealed that cognitive-affective patients were more likely to engage, attend more session, and overall improve, compared to patients whose depression was classed as somatic or typical.

Moreover, patients with a typical subtype were more likely to drop out of treatment altogether than those with cognitive-affective and somatic subtypes – indicating that for four in ten patients, CBT wasn’t necessarily the best treatment option.

Dr Melanie Simmonds-Buckley, University of Sheffield, lead author on the paper, commented on the findings: “Given how different depression can be from one person to the next, a treatment that works for one person may not work as well for another. Our findings have helped to identify how symptom profiles can be grouped into replicable subtypes of depression, showing that not all patients respond to CBT treatment in the same way.”

She added that future research would be concentrated on how other treatment options interact with the subtype groupings to assist in a more precise diagnosis and treatment selection, leading to improved outcomes for patients.”

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