Whether or not cognitive behavior therapy (CBT) will help a person recover from depression can be predicted through brain imaging, according to research results published by the University of Pittsburgh School of Medicine in the April issue of the American Journal of Psychiatry.
More than 17 million adults in the United States will experience at least one episode of major depression this year; of those who seek treatment, only 40 to 60 percent will respond to any given first-line treatment, whether it be therapy or medication. However, researchers have found that most eventually will respond once they find the right treatment. Being able to predict who will respond to CBT, and who will not, may prove to be a valuable tool for treating depression.
"For depression, there is no single medication or therapy that has been found to work as a primary treatment for most patients," said Greg J. Siegle, Ph.D., assistant professor of psychiatry, University of Pittsburgh School of Medicine. "We found that people with depression who have increased activity in one area of the brain and decreased activity in another in response to emotional stimuli are more likely to respond to a specific treatment--cognitive therapy. If this finding holds true, we may be able to predict what therapies will be most effective for individual patients by using imaging technology, bypassing the lengthy trial and error process that is often necessary to find the right treatment."
The study used functional magnetic resonance imaging (fMRI) to identify which areas of the brain were active or inactive when exposed to a negative stimulus. While undergoing fMRI, 14 unmedicated participants with depression and 21 control subjects who had never reported symptoms of depression were presented with emotional words and asked if those words applied to them. The participants with depression then completed 16 sessions of CBT over 12 weeks as part of a larger clinical trial.