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Cognitive behavioral therapy for depression among adults in Japanese clinical settings: a single-group study

Daisuke Fujisawa12*, Atsuo Nakagawa1, Miyuki Tajima3, Mitsuhiro Sado1, Toshiaki Kikuchi1, Motomi Hanaoka4 and Yutaka Ono5

Author Affiliations

1 Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, Japan

2 Psycho-Oncology Division, National Cancer Center East, 6-5-1 Kashiwanoha, Kashiwa-shi, Chiba, Japan

3 Stress Management Office, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo Japan

4 Department of Neuropsychiatry, Tokyo Women's University School of Medicine, 8-1Kawatacho, Shinjuku-ku, Tokyo, Japan

5 Health Management Center, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo Japan

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BMC Research Notes 2010, 3:160  doi:10.1186/1756-0500-3-160

Published: 7 June 2010



Empirical support for cognitive behavioral therapy (CBT) for treating Japanese patients with major depression is lacking, therefore, a feasibility study of CBT for depression in Japanese clinical settings is urgently required.


A culturally adapted, 16-week manualized individual CBT program for Japanese patients with major depressive disorder was developed. A total of 27 patients with major depression were enrolled in a single-group study with the purpose of testing the feasibility of the program. Twenty six patients (96%) completed the study. The mean total score on the Beck Depression Inventory-II (BDI-II) for all patients (Intention-to-treat sample) improved from 32.6 to 11.7, with a mean change of 20.8 (95% confidence interval: 17.0 to 24.8). Within-group effect size at the endpoint assessment was 2.64 (Cohen's d). Twenty-one patients (77.7%) showed treatment response and 17 patients (63.0%) achieved remission at the end of the program. Significant improvement was observed in measurement of subjective and objective depression severity (assessed by BDI-II, Quick Inventory of Depressive Symptomatology-Self Rated, and Hamilton Depression Rating Scale), dysfunctional attitude (assessed by Dysfunctional Attitude Scale), global functioning (assessed by Global Assessment of Functioning of DSM-IV) and subjective well-being (assessed by WHO Subjective Well-being Inventory) (all p values < 0.001).


Our manualized treatment comprised of a 16-week individual CBT program for major depression appears feasible and may achieve favorable treatment outcomes among Japanese patients with major depression. Further research involving a larger sample in a randomized, controlled trial design is warranted.

Trial registration

UMIN-CTR UMIN000002542.