Table 2.
Details of comparative studies (9 cases).
| Study | Methods | Results | Effect sizes† | ||
|---|---|---|---|---|---|
| Subjects | Therapist(s) | Design | |||
| Kobori et al. (2014) [19] | Patients with anxiety disorders (obsessive-compulsive disorder, anorexia, and social anxiety disorder) | 3 nurses; 3 doctors; 1 pharmacist; 2 psychiatric social workers; 13 clinical psychologists | Single-arm trial (n = 45); 12 weekly sessions of 50-minute individual CBT | Symptoms of depression (PHQ-9) and anxiety (GAD-7) improved significantly after intervention (p < 0.05) | Moderate effect on PHQ-9 (d = 0.68, 95% CI −0.08 to 1.39) and GAD-7 (d = 0.75, 95% CI −0.01 to 1.46) |
|
| |||||
| Okada (2013) [17] | Female patients with unipolar depression | 1-2 nurses | Single-arm trial (n = 78); 8 weekly sessions of 90-minute group CBT | Depressive symptoms (BDI-II) improvement after intervention (p < 0.05); improvement in cognitive impairment (DAS24) within 6 months of completion of intervention (p < 0.05); improvement in cognition and behavior in everyday life and with respect to other significant ones (interview data) | Moderate effect on BDI-II (d = 0.51, 95% CI −0.23 to 1.22) |
|
| |||||
| Kunikata (2013) [18] | Persons with psychiatric illnesses living in the community (schizophrenia and mood disorder) | 1 director (nurse); 1 facilitator (nurse) | Single-arm trial (n = 6); 12 biweekly sessions of 120-minute group CBT | No significant changes in self-esteem (RSES) or mood status (POMS) before and after intervention; mental sense of control (WHO-SUBI subscale) and psychiatric symptoms (BPRS) showing improvement before and after intervention (p < 0.05) | Moderate effect on RSES (d = 0.65, 95% CI −1.36 to 0.10) |
|
| |||||
| Yoshinaga et al. (2013) [20] | Patients with social anxiety disorder | 1 nurse; 1 doctor; 3 clinical psychologists; 1 psychiatric social worker | Single-arm trial (n = 15); 14 weekly sessions of 90-minute individual CBT | Social anxiety symptoms (LSAS, SPS, SIAS, FQ-SP, SFNE) showed improvement during and at the end of intervention (p < 0.05); after intervention, 73% of participants were judged to be treatment responders and 40% met the criteria for remission | Large effect on LSAS (d = 1.56, 95% CI 0.70 to 2.33) |
|
| |||||
| Sakano et al. (2010) [21] | Inpatients with major depressive disorder and the related depressive symptoms | 1 trainer (psychologist); 1-2 subtrainers (psychologist and nurse) | Single-arm trial (n = 54); 5 weekly sessions of 60-minute group CBT (for improving adequate emotional expression and interpersonal skills, inhibition of aggression, and preventing depression) | Depressive symptoms (BDI), social interaction anxiety (SIAS), social skills (SSS), fear of negative evaluation (SFNE), and QOL (WHOQOL-26) all showed improvement after the intervention (p < 0.05). In follow-up, improvement of fear of negative evaluation (SFNE) was maintained; long-term maintenance of other improvements was not observed | Moderate effect on BDI (d = 0.58, 95% CI −0.16 to 1.30) |
|
| |||||
| Sakano et al. (2010) [22] | Inpatients with major depressive disorder and the related depressive symptoms | 1 trainer (psychologist); 1-2 subtrainers (psychologist and nurse) | Single-arm trial (n = 62); 5 weekly sessions of 60-minute group CBT (for improving stress coping and depression) | After the intervention, anxiety and depressive symptoms (BDI, SRS-18 sub-items), lethargy (SRS-18 sub-items), and QOL (WHOQOL-26) showed improvement (p < 0.05); additionally, diversification of stress coping strategies (TAC-24) and increased ability to control stress (CARS) were observed (p < 0.05); however, long-term effects were not observed | Small effect on BDI (d = 0.29, 95% CI −0.44 to 1.00) |
|
| |||||
| Watanabe et al. (2011) [16] | Patients with residual depression and refractory insomnia | 5 doctors; 1 nurse | Randomized controlled trial; intervention group (n = 20) received usual care + 4 weekly sessions of 40-minute individual CBT; control group (n = 17) received only usual care | Compared to the control group, the intervention group's insomnia (ISI) and depressive symptoms (GRID-HAMD) had improved (p < 0.05) | Large effect on ISI (d = 1.79, 95% CI 0.90 to 2.58) |
|
| |||||
| Kumagai et al. (2003) [15] | Hospitalized patients with schizophrenia | 1 nurse | Randomized controlled trial; intervention group (n = 16) received group occupational therapy + 16 twice-weekly sessions of 120-minute group CBT; control group (n = 15) received only group occupational therapy | Compared to the control group, the intervention group had improved knowledge of disease self-management, speech skill, and social activity score (REHAB sub-items); there was no significant difference in QOL (WHOQOL-26) between the two groups | Moderate effect on DS score of REHAB (d = 0.63, 95% CI −0.12 to 1.34) |
|
| |||||
| Okuno et al. (2000) [23] | Elderly patients with depression | 2 doctors; 1 nurse (observer) | Single-arm trial (n = 18); 8 weekly sessions of 60-minute group CBT | After the intervention, 7 patients (39%) showed improvement (BDI reduction rate > 50%); regarding BDI subscale, loss of interest/pleasure and hypochondriac showed significant improvement (p < 0.01), and suppression, depressed mood, self-denial, and physical symptoms, also significantly improved (p < 0.05) | Large effect on BDI (d = 1.04, 95% CI 0.25 to 1.77) |
†Pre- to posteffect sizes (Cohen's d) of CBT arm for each study were recalculated using same formula. BDI-II, Beck Depression Inventory-II; BPRS, Brief Psychiatric Rating Scale; CARS, Cognitive Appraisal Rating Scale; CBT, Cognitive Behavioral Therapy; DAS24, Dysfunctional Attitude Scale-24; FQ-SP, Fear Questionnaire-Social Phobia Subscale; GAD-7, Generalized Anxiety Disorder-7; GRID-HAMD, GRID-Hamilton Depression Rating Scale; ISI, Insomnia Severity Index; LSAS, Liebowitz Social Anxiety Scale; PHQ-9, Patient Health Questionnaire-9; POMS, Profile of Mood States; REHAB, Rehabilitation Evaluation of Hall and Baker; RSES, Rosenberg Self-Esteem Scale; SFNE, Short Form Fear Of Negative Evaluation; SIAS, Social Interaction Anxiety Scale; SPS, Social Phobia Scale; SRS-18, Stress Response Scale; SSS, Social Skills Scale; TAC-24, Tri-axial Coping Scale-24; WHO-SUBI, WHO-Subjective Well-Being Inventory; WHOQOL-26, WHO Quality of Life-26.