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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
Version: Published version
Publication type: Zeitschriftenaufsatz
License: CC BY-NC-ND
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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

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