Combined Cognitive-Behavioral Therapy and Placebo Treatment for Patients with Depression: A Follow-Up Assessment

Abstract

Introduction A previous study revealed that patients with depression who received a combination of cognitive-behavioral therapy (CBT) and placebo treatment (CBT+placebo) showed greater symptom reduction than a CBT group without a placebo. Moreover, the CBT+placebo group practiced relaxation training more frequently. We conducted a 3-month follow-up assessment to investigate the temporal stability of the placebo effects. Methods Eighty-two outpatients with a diagnosis of major depressive disorder who had participated in a 4-week CBT course (CBT: n = 40; CBT with daily placebo treatment: n = 42) returned to a 3-month follow-up assessment. The participants of the CBT+placebo group had been debriefed directly after the course. Results Compared to the CBT group, the CBT+placebo group had lower scores on the Beck Depression Inventory-II (BDI-II) at follow-up and more participants were below the clinical cut-off score of the BDI-II. Additionally, the CBT+placebo group continued to practice relaxation more frequently. Discussion This study demonstrates that placebo effects are not short-lived and continue to be present after the debriefing.

Placebo effects during the waiting period for psychotherapy in patients with depression

“…It is important to note that patients' responses to the debriefing were very positive when they learned that they were responsible for the improvements during the waiting time. Similar debriefing effects (e.g., feelings of mastery, and pride) have been reported in a study where the placebo (also introduced as a mobilizer of the body's natural healing powers) had been administered during CBT (Schienle & Jurinec, 2021). Moreover, the patients of the placebo group still showed lower BDI scores compared to the standard group during a follow-up assessment (three months after the therapy).…”

“…In a placebo study by Jurinec and Schienle (2020), the patients were randomly assigned to either a standardized four-week CBT program (CBT group) or the same program with additional daily placebo treatment ('herbal medicine to mobilize the body's natural healing powers'; CBT + placebo group). The CBT + placebo group showed greater symptom reduction (as measured with the Beck Depression Inventory-II) directly after the therapy as well as during the three-month follow-up assessment (Schienle & Jurinec, 2021). Thus, in the context of CBT, placebos are effective and enhance the therapy outcome.…”