BACKGROUND: The efficacy of CBT for unipolar depressive disorders is well established, yet not all patients improve or tolerate treatment. AIMS: To identify factors associated with symptomatic outcome, response, and drop-out in depressive patients under naturalistic CBT. METHOD: 193 patients with major depression or dysthymia were tested. Sociodemographic and clinical variables were entered as predictors in hierarchical regression analyses. RESULTS: A higher degree of pretreatment depression, early improvement, and completion of therapy were identified as predictors for symptomatic change and response. Drop-out was predicted by concurrent personality disorder, less positive outcome expectancies, and by failure to improve early in treatment. CONCLUSIONS: Our results highlight the importance of early response to predict improvement in routine CBT. Attempts to refine the quality of treatment programs should focus on avoiding premature termination (drop-out) and consider motivational factors in more depth. Routinely administered standardized assessments would enhance symptom monitoring and help to identify persons at risk of not improving under therapy.
BACKGROUND: The efficacy of CBT for unipolar depressive disorders is well established, yet not all patients improve or tolerate treatment. AIMS: To identify factors associated with symptomatic outcome, response, and drop-out in depressivepatients under naturalistic CBT. METHOD: 193 patients with major depression or dysthymia were tested. Sociodemographic and clinical variables were entered as predictors in hierarchical regression analyses. RESULTS: A higher degree of pretreatment depression, early improvement, and completion of therapy were identified as predictors for symptomatic change and response. Drop-out was predicted by concurrent personality disorder, less positive outcome expectancies, and by failure to improve early in treatment. CONCLUSIONS: Our results highlight the importance of early response to predict improvement in routine CBT. Attempts to refine the quality of treatment programs should focus on avoiding premature termination (drop-out) and consider motivational factors in more depth. Routinely administered standardized assessments would enhance symptom monitoring and help to identify persons at risk of not improving under therapy.
Authors: Kirsti A Campbell; Brian C Healy; Christopher M Celano; Ariana Albanese; Rachel A Millstein; Jeff C Huffman Journal: J Psychosom Res Date: 2018-06-13 Impact factor: 3.006
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Authors: D A van Dijk; M L Deen; Th M van den Boogaard; H G Ruhé; J Spijker; F P M L Peeters Journal: Eur Arch Psychiatry Clin Neurosci Date: 2022-10-17 Impact factor: 5.760
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Authors: A M Boerema; P Cuijpers; A T F Beekman; A Hellenthal; L Voorrips; A van Straten Journal: Soc Psychiatry Psychiatr Epidemiol Date: 2016-07-23 Impact factor: 4.328