Mindfulness-based cognitive therapy and a group version of the cognitive behavioral analysis system of psychotherapy for chronic depression
Year: 2016
Type: article
Abstract: CBASP: n = 35; MBCT: n = 36) gave their written informed consent.The Research Ethics Committee of the German Psychological Association approved the study (JM072009), and the study was registered at www.clinicaltrials.gov(NCT01065311).As outcome measures, the Hamilton Depression Rating Scale, 24-item version (HAM-D) and the Beck Depression Inventory, second edition (BDI-II) were administered at three measurement points: t0 = pretreatment, t1 = post-treatment, and t2 = follow-up.Moreover, the Childhood Trauma Questionnaire was administered at t0. Between t1 and t2, the CBASP and MBCT patients received two booster sessions of 2.5 h each.The MBCT booster sessions included formal mindfulness exercises as well as support in mindful coping with mood deterioration and difficulties when exercising mindfulness; the CBASP booster sessions comprised summarizing the patients' efforts in applying the strategies learned in group therapy and conducting further situation analyses.Eighty-five patients (TAU: n = 32; CBASP: n = 25; MBCT: n = 28) participated in the t1 and 57 patients (TAU: n = 18; CBASP: n = 20; MBCT: n = 19) in the t2 assessment.The t2 assessment took place at a mean of 6.33 months (SD = 1.92; min.= 3.88; max.= 18.07) after t1; the 3 treatment conditions did not differ significantly in the time interval between t1 and t2.Within the follow-up sample, the treatment conditions differed neither in medication with antidepressants at the time of follow-up nor in baseline variables, except for age (F 2, 53 = 3.47; p ≤ 0.05), with MBCT patients being younger than TAU patients (p ≤ 0.05).Dropout analysis revealed that the participants of the follow-up and the dropouts were comparable in baseline variables except for gender, i.e. more female patients took part in the follow-up (χ 2 (1) = 4.90; p ≤ 0.05).The dropout rates did not differ significantly between the treatment conditions.Yet, more patients who were classified as remitted (HAM-D ≤ 8, BDI-II ≤ 12) at t1 participated in the follow-up (HAM-D: χ 2 (1) = 6.65, p ≤ 0.05; BDI-II: χ 2 (1) = 9.91, p ≤ 0.05).Patients who did not take part in the t1 or t2 assessment as well as participating patients with missing values on the HAM-D/BDI-II were classified as nonremitted on the HAM-D/BDI-II at t1 and t2 (intent-to-treat analysis; ITT).The ITT remission rates at follow-up differed between the 3 treatment conditions on the HAM-D (χ 2 (2) = 9.30; p ≤ 0.05) and on the BDI-II (χ 2 (2) = 6.57; p ≤ 0.05).More specifically, CBASP patients were more likely to remit than TAU patients on both the HAM-D (ITT: 22.86 vs. 0%; χ 2 (1) = 9.03; p ≤ 0.05) and the BDI-II (ITT: 22.86 vs. 2.86%; χ 2 (1) = 6.25; p ≤ 0.05).MBCT patients, however, remitted significantly more than TAU patients only on the HAM-D (ITT: 22.22 vs. 0%; χ 2 (1) = 8.77; p ≤ 0.05), but not on the BDI-II (ITT: 11.11 vs. 2.86%).CBASP and MBCT did not differ significantly in their ITT remission rates at follow-up either on the HAM-D or the BDI-II.Multilevel models for discontinuous change (with t1 as the reference) evaluated the moderating role of childhood adversities (Childhood Trauma Questionnaire) on the course of depressive symptoms (HAM-D, BDI-II) from t0 to t1 as well as from t1 to t2.Childhood adversities did not moderate treatment outcomes between CBASP and MBCT.In the comparison of
Authors: Michalak, Johannes (Prof. Dr.), Probst, Thomas (Dr. rer. nat.), Heidenreich, Thomas (Prof. Dr.), Bissantz, Nicolai, Schramm, Elisabeth (Prof. Dr.)
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
Funder: Deutsche Forschungsgemeinschaft
OpenAlex ID: W6992815028