Feasibility and acceptability of group CBT+CRT for adults with major depressive disorders in an Iranian community: a single group study

Abstract

Background Despite significant advances in the psychological treatment of Major Depressive Disorder (MDD), many treatment challenges remain, such as high recurrence and functional impairment after treatment. It seems that ignoring underlying factors such as cold cognitive dysfunctions plays an important role in these therapeutic challenges. Although a lot of research has been done on hot cognition, cold cognition is about neglect. Therefore, the purpose of this study was to assess the feasibility and acceptability and to estimate the effect size of the group CBT+CRT for future controlled trials. Methods Among the 31 volunteers who were diagnosed with MDD in the online clinical interview, 14 adults aged 22-40 years were treated in 12 weekly two-hour sessions. Only 12 patients remained in the study at week 12. Psychological and neuropsychological assessments were evaluated by the Beck Depression Inventory-Second Edition (BDI-II), the Snaith-Hamilton Pleasure Scale (SHAPS), and the THINC-it tool. Results Data analysis showed that psychological symptoms of depression were significantly reduced at post-test and at follow-up compared to pre-test based on BDI-II and SHAPS scores. Regarding neuropsychological symptoms, effect sizes were largest for attention (d=−1.37) and processing speed (d=−1.18), but smaller effect sizes were observed for working memory (d=−0.26) and executive functioning (d=−0.54). The observed effect sizes remained relatively stable at the three-month follow-up. Conclusion To the authors' knowledge, this is the first study to evaluate group CBT+CRT for adults with MDD designed based on the hot-cold cognition model of depression, stimulating further developmental research. In general, the results showed the sufficient feasibility and acceptance of this treatment manual.