Efficacy of attributional retraining group therapy versus selective serotonin reuptake inhibitors for depression and anxiety: a case-control study

Abstract

Objective To explore the efficacy of attributional retraining group therapy (ARGT) versus selective serotonin reuptake inhibitors (SSRIs) on depression and anxiety of depressive disorder, anxiety disorder and obsessive compulsive disorder, and to compare the preferential target between two treatments. Methods In a case-control study design, outpatients with major depressive disorder, anxiety disorder and obsessive-compulsive disorder were recruited and randomized into ARGT group (n=63) and SSRIs group (n=66) by a blocking random control. All patients were measured with HAMD24 and HAMA at baseline and week 2, 4, 6, 8. Self-Rating Depression Scale and Self-Rating Anxiety Scale were also both utilized before and after 8 weeks treatment. Results Fifty-four outpatients in ARGT group and 55 outpatients in SSRIs group completed the study. At the end of the treatment, all symptom scores were significantly reduced with big effect size (d>0.8) in both ARGT group and SSRIs group (P<0.01). By mixed-effects linear model there were no significant differences in total scores of HAMD24 and HAMA between two groups at any visit (F=2.652, P=0.104; F=0.384, P=0.536) . The subscale scores of cognition disturbance, retardation and hopelessness of HAMD24 were lower in ARGT group than SSRIs group (F=6.932, 14.155, 7.594, all P<0.01) , and the diurnal variation score was lower in SSRIs group than ARGT group (0.138 vs. 0.299; F=27.986, P<0.01) . For HAMA subscale symptoms, the scores of depressed (0.885 vs. 0.981; F=4.869, P<0.05) and behavior at interview (0.685 vs. 0.805; F=8.001, P<0.01) were lower in ARGT group and the score of anxious emotions was lower in SSRIs group (0.940 vs. 1.129; F=18.075, P<0.05). Conclusions Both ARGT and SSRIs can significantly improve in depressive and anxiety symptoms. The overall preferential target symptoms of ARGT should be mainly cognition disturbance, retardation, hopelessness, depressed mood and behavior at interview, while SSRIs will be good at diurnal variation and anxious emotions. Key words: Depression; Anxiety; Attributional retraining group therapy; Selective serotonin reuptake inhibitors