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

Annette Schaub,Jana Kopinke

doi:10.4172/2572-0791.1000115

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.

Highlights

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 [1,2,3,4,5,6,7]
Limitations: The absence of a control group limits the conclusions that can be drawn from this study. 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
This paper focuses on the implementation and evaluation of a cognitive psycho educational treatment program with psychiatric inpatients suffering from depression [12]

Summary

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 [1,2,3,4,5,6,7]. 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 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

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Methods

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Discussion

Conclusion