Brief report ‘‘Coping with depression’’: an open study of the efficacy of a group psychoeducational intervention in chronic, treatment-refractory depression John Swan * , Eleanor Sorrell, Bob MacVicar, Rob Durham, Keith Matthews Department of Psychiatry, University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, UK Received 19 May 2003; received in revised form 15 September 2003; accepted 15 September 2003 Abstract Background: Failure to respond to antidepressant medication represents a major clinical problem. Few therapeutic interventions have been shown to benefit such individuals. Method: Patients attended a 12-session psychoeducational programme over a period of 10 weeks, with follow-up at 26 weeks. The main outcome measures were the self-report Beck Depression Inventory (BDI-II), the Global Severity Index (GSI) of the Brief Symptom Inventory (BSI) and the EuroQol 5D. Results: Baseline assessments confirmed substantial chronicity and treatment resistance, high symptom burden and poor quality of life in the study cohort. Twenty-six week follow-up data were obtained from 34% of cohort. Completion of the course was associated with clinically significant changes in symptom burden. Sustained remission was achieved by 35% of completers. Limitations: We did not characterise the cohort using structured clinical interview and did not collect structured, objective ratings of mental health status. There was no control group. There was a high attrition rate and caution must be exercised in interpreting results. Conclusions: For a proportion of patients with chronic depressive episodes that have not responded to antidepressant treatments, the ‘‘Coping with Depression’’ psychoeducational group may confer sustained and meaningful benefit. Controlled studies are warranted. D 2003 Elsevier B.V. All rights reserved. Keywords: Depression; Chronic; Treatment refractory; Psychoeducational; ‘‘Coping with depression’’ 1. Introduction Between 30–40% of depressive episodes respond poorly to antidepressant medication, with a significant proportion meeting criteria for chronicity (Thase, 2001). Despite this, a recent systematic review of the efficacy of pharmacological and psychological inter- ventions for treatment-refractory depression found no randomised, controlled trials (RCT) that assessed the efficacy of psychotherapy and little evidence on which to guide pharmacological management (Stimpson et al., 2002). Not included in this review, however, were two recent, large-scale, RCTs investigating the benefits of combining psychotherapy and pharmacotherapy in populations. Keller et al. (2000) randomised 681 patients with chronic, nonpsychotic depression to the antidepres- 0165-0327/$ - see front matter D 2003 Elsevier B.V. All rights reserved. doi:10.1016/j.jad.2003.09.002 * Corresponding author. Tel.: +44-1382-632121; fax: +44- 1382-633923. E-mail address: j.s.swan@dundee.ac.uk (J. Swan). www.elsevier.com/locate/jad Journal of Affective Disorders 82 (2004) 125 – 129