alexa A Cognitive Behavioural Illness Management Program for Severe Depression: Predictors of Treatment Response
ISSN: 2572-0791

Clinical Depression
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Research Article

A Cognitive Behavioural Illness Management Program for Severe Depression: Predictors of Treatment Response

Annette Schaub1* and Jana Kopinke2

1Department of Psychiatry and Psychotherapy, University of Munich, Nussbaumstrasse 7, 80336 Munich, Germany

2Private Praxis, Grabenackerstr, 6312 Steinhausen, Switzerland

*Corresponding Author:
Annette Schaub
Clinical Research Psychologist
Department of Psychiatry and Psychotherapy
University of Munich, Nussbaumstrasse 7
80336 Munich, Germany
Tel: 0049-89-4400-52779
E-mail: [email protected]

Received Date: October 02, 2015; Accepted Date: August 30, 2016 Published Date: September 06, 2016

Citation: Schaub A, Kopinke J (2016) A Cognitive Behavioural Illness Management Program for Severe Depression: Predictors of Treatment Response. Clin Depress 2:115. doi:10.4172/2572-0791.1000117

Copyright: © 2016 Schaub A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Background: Although combined pharmacotherapy and teaching illness management are the standard in the treatment of depressed inpatients, few studies have been reported of the effects of these programs. The purpose of this study was to determine the applicability and preliminary effectiveness of a brief, group-based cognitivebehavioural illness management program for depression, and to explore whether patient socio demographic and clinical characteristics predicted differential treatment response. Methods: 97 inpatients with a major depression participated in a 6-week treatment program providing psycho education and skills to cope with the illness. Psychopathology, global functioning, knowledge about depression, selfesteem covering areas of problem solving, assertiveness and social competence were assessed as dependent variables. Results: Overall, patients improved over the treatment period on most dimensions of psychopathology, knowledge about depression, and self-esteem. There was little evidence of differential treatment response as a function of either socio demographic or clinical variables. However, level of education was related to changes in psychopathology from pre- to post-treatment with higher educated patients benefiting most. Patients who were rapidly discharged from the hospital benefited more than inpatients in symptoms and problem solving skills. At twoand six year follow-ups, characteristics such as age and duration of illness were the only significant predictors for relapses. Limitations: The absence of a control group limits the conclusions that can be drawn from this study. Conclusion: These results suggest that this illness management program may be a useful approach to treating patients with severe depression, and that it warrants further investigation in a controlled study. Keywords: Severe depression; Inpatient treatment; Illness management; Cognitive-behaviour therapy; Psycho education; Predictors; Psychopathology Introduction Pharmacological treatment is the mainstay in the management of recurrent depression, but accumulating evidence supports the role of cognitive behavioural therapy (CBT) as an important ingredient in comprehensive treatment programs for acute treatment and relapse prevention [1-7]. Cognitive Beck et al. [8] and interpersonal therapy Klerman et al. [9] are the most rapidly growing approaches for improving knowledge about the illness, symptoms, interpersonal competence as well as relapse prevention skills of patients with depression. New approaches mainly developed for the treatment of partially remitted or chronic forms of depression include the cognitive behavioural-analysis system of psychotherapy McCullough et al. [10], mindfulness based cognitive therapy Segal et al. [11] and cognitivepsycho educational interventions [12]. They are all based on cognitive techniques. The first additionally draws on behavioural Lewinsohn et al. [13] and interpersonal strategies Klerman et al. [9], the second on stress reduction Kabat Zinn [14] and the

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