Effect of Cognitive Behavioral Therapy on Depression
DOI:
https://doi.org/10.61919/0wfjr325Keywords:
Migraine with aura; MIDAS; MSQ; disability; bankers; ICHD-3.Abstract
Background: Depression is a prevalent and disabling condition, and brief, structured psychotherapies that can be delivered efficiently remain important in applied settings. Objective: To evaluate whether a brief five-session cognitive behavioral therapy (CBT) program is associated with reduced depressive symptom severity measured using the DASS-21 depression subscale. Methods: A single-arm pre–post (pre-experimental) study delivered five individual CBT sessions of approximately 60 minutes over two months. Depressive symptoms were assessed immediately before the first session and after completion of the fifth session. The prespecified primary endpoint was within-participant change in DASS-21 depression score. Analyses emphasized paired change estimates with exploratory inferential testing. Results: Among eligible participants with baseline depressive symptoms (n=5), mean DASS-21 depression scores decreased from 7.2±1.9 to 5.2±1.3, with a mean paired reduction of 2.0 points (95% CI: -3.24 to -0.76) and a large within-subject effect size (Cohen’s dz=-2.00). Severity-category transitions showed 80% improved by at least one category, including 100% of mild cases shifting to normal and 66.7% of moderate cases shifting to mild. Conclusion: Depressive symptom scores and severity categories improved in most participants after brief CBT, supporting feasibility and suggesting potential benefit, while indicating the need for larger controlled studies with prespecified follow-up to confirm effectiveness. Keywords: cognitive behavioral therapy; depression; DASS-21; brief psychotherapy; pre–post study.
References
1. Murray CJ, Lopez AD. The Global Burden of Disease: a comprehensive assessment of mortality and disability from diseases, injuries and risk factors in 1990 and projected to 2020. Vol I. Cambridge (MA): Harvard School of Public Health; 1996.
2. Moussavi S, Chatterji S, Verdes E, Tandon A, Patel V, Ustun B. Depression, chronic diseases, and decrements in health: results from the World Health Surveys. Lancet. 2007;370:851–58.
3. Tyrer P. Are general practitioners really unable to diagnose depression? Lancet. 2009;374:589–90.
4. Mitchell AJ, Vaze A, Rao S. Clinical diagnosis of depression in primary care: a meta-analysis. Lancet. 2009;374:609–19.
5. Watson JB. Psychology as the behaviorist views it. Psychol Rev. 1913;20(2):158.
6. Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive therapy of depression. New York: Guilford Press; 1979.
7. Butler AC, Chapman JE, Forman EM, Beck AT. The empirical status of cognitive-behavioral therapy: a review of meta-analyses. Clin Psychol Rev. 2006;26(1):17–31.
8. Johnsen TJ, Friborg O. The effects of cognitive behavioral therapy as an anti-depressive treatment is falling: A meta-analysis. Psychol Bull. 2015;141(4):747.
9. Howard KI, Kopta SM, Krause MS, Orlinsky DE. The dose–effect relationship in psychotherapy. Am Psychol. 1986;41(2):159.
10. Shafran R, Clark DM, Fairburn CG, Arntz A, Barlow DH, Ehlers A, et al. Mind the gap: Improving the dissemination of CBT. Behav Res Ther. 2009;47(11):902–09.
11. Kessler RC, Berglund P, Demler O, Jin R, Koretz D, Merikangas KR, et al. The epidemiology of major depressive disorder: results from the National Comorbidity Survey Replication (NCS-R). JAMA. 2003;289:3095–105.
12. Penninx BW, Nolen WA, Lamers F, Zitman FG, Smit JH, Spinhoven P, et al. Two-year course of depressive and anxiety disorders: results from the Netherlands Study of Depression and Anxiety (NESDA). J Affect Disord. 2011;133(1-2):76–85.
13. Das-Munshi J, Goldberg D, Bebbington PE, et al. Public health significance of mixed anxiety and depression: beyond current classification. Br J Psychiatry. 2008;192:171–77.
14. Friborg O, Martinsen EW, Martinussen M, Kaiser S, Øvergård KT, Rosenvinge JH. Comorbidity of personality disorders in mood disorders: a meta-analytic review of 122 studies from 1988 to 2010. J Affect Disord. 2014;152:1–11.
15. Newton-Howes G, Tyrer P, Johnson T. Personality disorder and the outcome of depression: meta-analysis of published studies. Br J Psychiatry. 2006;188(1):13–20.
16. Yoshimura S, Okamoto Y, Onoda K, Matsunaga M, Okada G, Kunisato Y, et al. Cognitive behavioral therapy for depression changes medial prefrontal and ventral anterior cingulate cortex activity associated with self-referential processing. Soc Cogn Affect Neurosci. 2014;9(4):487–93.
17. Siegle GJ, Ghinassi F, Thase ME. Neurobehavioral therapies in the 21st century: Summary of an emerging field and an extended example of cognitive control training for depression. Cogn Ther Res. 2007;31(2):235–62.
18. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33(3):335–43.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Ahmed Hassan Dar (Author)
This work is licensed under a Creative Commons Attribution 4.0 International License.
