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Longitudinal Clusters of Long-Term Trajectories in Patients with Early-Onset Chronic Depression: 2 Years of Naturalistic Follow-Up after Extensive Psychological Treatment.
Elsaesser, Moritz; Feige, Bernd; Kriston, Levente; Schumacher, Lea; Peifer, Jasmin; Hautzinger, Martin; Härter, Martin; Schramm, Elisabeth.
Afiliación
  • Elsaesser M; Department of Psychiatry and Psychotherapy, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Feige B; Department of Psychiatry and Psychotherapy, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Kriston L; Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Schumacher L; Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Peifer J; Department of Psychiatry and Psychotherapy, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  • Hautzinger M; Department of Psychology, Eberhard Karls University of Tübingen, Tübingen, Germany.
  • Härter M; Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
  • Schramm E; Department of Psychiatry and Psychotherapy, Medical Center and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Psychother Psychosom ; 93(1): 65-74, 2024.
Article en En | MEDLINE | ID: mdl-38154457
ABSTRACT

INTRODUCTION:

In clinical trials, mostly group-level treatment effects of repeated cross-sectional measures are analyzed. However, substantial heterogeneity regarding individual symptom profiles and the variability of treatment effects are often neglected, especially over the long-term course. To provide effective personalized treatments, investigations of these characteristics are urgently needed.

METHODS:

Depression severity ratings over 104 weeks of follow-up after year-long treatment with the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) or Supportive Psychotherapy (SP) were analyzed. Longitudinal cluster analysis and multinomial logistic regression analysis were conducted to investigate intraindividual trajectories from one of the largest psychotherapy trials in early-onset chronic depression.

RESULTS:

Two-year post-study-treatment trajectories of N = 188 patients with early-onset chronic depression were grouped into four prototypical clusters. Overall, 16.0% of patients remitted (cluster 1) and most of them did not receive any treatment during the 2-year follow-up. However, 84.0% of patients continued to experience subthreshold (37.2% cluster 2) or major depressive symptoms (46.8% clusters 3-4) and spent on average more than half of the follow-up in pharmacological and psychological treatment. Hierarchical regression analysis indicated that previous study treatment with CBASP or SP did not significantly predict cluster allocation, while baseline variables accounted for a large proportion of explained variance (R2 N = 0.64).

CONCLUSION:

While some patients experienced stable remission over 2 years of follow-up, the majority of patients experienced subthreshold or major depressive symptoms regardless of former study treatment with CBASP or SP. This calls for a long-term perspective implementing staging and innovative treatment approaches such as the sequential model or modular psychotherapy.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Depresión / Trastorno Depresivo Mayor Límite: Humans Idioma: En Revista: Psychother Psychosom Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Depresión / Trastorno Depresivo Mayor Límite: Humans Idioma: En Revista: Psychother Psychosom Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Suiza