当前位置： SCI文献检索 > JOURNAL OF AFFECTIVE DISORDERS期刊下所有文献 > Therapist-rated outcomes in a randomized clinical trial comparing cognitive behavioral therapy and psychodynamic therapy for major depression.

Therapist-rated outcomes in a randomized clinical trial comparing cognitive behavioral therapy and psychodynamic therapy for major depression.

Abstract：

BACKGROUND:The efficacy of psychodynamic therapy (PDT) for depression is debated due to a paucity of high-quality studies. We compared short psychodynamic supportive psychotherapy (SPSP) to cognitive behavioral therapy (CBT) in a randomized clinical trial. We used therapist-rated outcomes to examine how the course of change during treatment could be best represented and to compare treatment efficacy, hypothesizing non-significant differences. METHODS:Three hundred and forty-one adults meeting DSM-IV criteria for a depressive episode and with Hamilton Depression Rating Scale (HAM-D) scores ≥14 were randomized to 16 sessions of individual manualized CBT or SPSP. Severely depressed patients (HAM-D>24) received additional antidepressant medication. After each session, therapists rated the Clinical Global Impression Scale subscales 'Severity of Illness' (CGI-S) and 'Global Improvement' (CGI-I), and the DSM-IV Axis V Global Assessment of Functioning Scale (GAF). We fitted growth curves using mixed model analyses with intention-to-treat samples. RESULTS:CGI-S and GAF scores during treatment were best represented by a linear symptom decrease. CGI-I scores were best represented by an S-shaped curve with relative more improvement in the first and last phases than in the middle phase of treatment. No significant post-treatment treatment differences were found. A non-significant trend for a treatment effect on CGI-S scores vanished when controlling for therapist gender and profession. LIMITATIONS:Therapists were not specifically trained for CGI and GAF assessments. CONCLUSIONS:These findings add to the evidence-base of PDT for depression. Therapist characteristics and differences between severity and improvement measures might influence ratings and need to be taken into account when using therapist-rated outcome measures.

journal_name

J Affect Disord

journal_title

Journal of affective disorders

authors

Driessen E,Van Henricus L,Peen J,Don FJ,Kool S,Westra D,Hendriksen M,Cuijpers P,Twisk JW,Dekker JJ

doi

10.1016/j.jad.2014.08.023

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

112-8

eissn

0165-0327

issn

1573-2517

pii

S0165-0327(14)00512-6

journal_volume

170

pub_type

杂志文章,随机对照试验

在线工具

Therapist-rated outcomes in a randomized clinical trial comparing cognitive behavioral therapy and psychodynamic therapy for major depression.