Authors:	Beutel, Manfred Krakau, Lina Kaufhold, Johannes Bahrke, Ulrich Grabbhorn, Alexa Hautzinger, Martin Fiedler, Georg Kallenbach-Kaminski, Lisa Ernst, Mareike Rüger, Bernhard Leuzinger-Bohleber, Marianne
Title:	Recovery from chronic depression and structural change : 5-year outcomes after psychoanalytic and cognitive-behavioural long-term treatments (LAC depression study)
Online publication date:	25-Jan-2023
Year of first publication:	2022
Language:	english
Abstract:	Objective: Psychotherapy of chronic depression has remained a challenge due to limited prognosis and high rates of recurrence. We present 5-year outcome data from a multicentre trial comparing psychoanalytic (PAT) and cognitive-behavioural (CBT) long-term treatments with randomized and preferred allocations analysing symptom (N = 227) and structural change (N = 134) trajectories. Method: Self- and blinded expert ratings of depression symptoms were performed at yearly intervals using the Beck Depression Inventory-II (BDI-II) and Quick Inventory of Depressive Symptoms (QIDS-C). Blinded expert ratings of Operationalized Psychodynamic Diagnosis (OPD) and the Heidelberg Restructuring Scale (HRS) at baseline, 1, 3, and 5 years assessed structural change in a subsample. Results: Lasting and comparable symptom changes were achieved by PAT and CBT. However, compared to CBT, PAT was more successful in restructuring, a major goal of long-term psychodynamic treatments with high frequency and duration. Limitations: Due to practical reasons, the time criterion for chronic depression of an acute phase had to be defined for over 1 year in the present study, which does not correspond to the DSM-5 criterion of 2 years. Therapy duration and session frequency were not incorporated into the statistical models. Conclusion: Long-term psychotherapy helps patients with a yearlong history of depression and often multiple unsuccessful treatment attempts to achieve lasting symptom changes. Future follow-up will clarify whether restructuring promotes further sustainable improvements.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-8541
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY-NC-ND
Information on rights of use:	https://creativecommons.org/licenses/by-nc-nd/4.0/
Journal:	Clinical psychology & psychotherapy Version of Record (VoR)
Publisher:	Wiley
Publisher place:	New York, NY u.a.
Issue date:	2022
ISSN:	1099-0879
Publisher DOI:	10.1002/cpp.2793
Appears in collections:	DFG-491381577-H