Abstract
BackgroundOne in three people with a chronic somatic disease suffer from a comorbid mental disorder. Most common comorbidities are depressive, anxiety and adjustment disorders. These lead to an increase in morbidity and mortality, and a deterioration of quality of life and healthcare costs. Treatment of mental disorders is of great importance, but the waiting time for outpatient individual psychotherapy can be up to six months in Germany. Group therapy has comparable treatment effects and is considerably more economic than individual therapy; however, it is still almost unused in the outpatient care system. The introduction of a stepped care approach, such as attending a group program before individual therapy, could improve this issue. For this purpose we developed a group program (STEpS), and its efficacy will be evaluated in this study.Methods/DesignA randomized controlled trial will be conducted to evaluate the efficacy of a cognitive behavioral therapy (CBT) group program for patients with somatic diseases and depressive or adjustment disorders, compared to a wait-list control group. A total of 128 adults with any chronic somatic disease and comorbid depression or adjustment disorder will be recruited in our outpatient clinic, and will be randomly assigned to participate in the group program immediately after contacting the clinic (intervention group) or after a waiting period of four months (wait-list control group). Primary outcomes will be self-reported depressive and anxiety symptoms. Secondary outcomes will be self-reported psychological distress, changes in experience and behavior, health-related quality of life, state of self-esteem and subjective need for therapy. Assessments will take place at baseline, 10 weeks (post-treatment) and 18 weeks (follow-up) after randomization. Additionally, treatment acceptance and psychotherapeutic process will be assessed after each session.DiscussionThis study investigates whether the CBT group program is an effective treatment to reduce depressive and anxiety symptoms and psychological distress in these patients. If the group program is effective, it could be implemented as a treatment option prior to individual outpatient therapy. These results will contribute to improving outpatient care for mental disorders in patients with somatic diseases.Trial registrationGerman Clinical Trials Register DRKS00005140 (27 August 2013).
Highlights
Introduction of theMoVo concept [62] and illustration of the different steps in the motivational and volitional process of physical activity
This study investigates whether the cognitive behavioral therapy (CBT) group program is an effective treatment to reduce depressive and anxiety symptoms and psychological distress in these patients
These results will contribute to improving outpatient care for mental disorders in patients with somatic diseases
Summary
Introduction of theMoVo concept [62] and illustration of the different steps in the motivational and volitional process of physical activity. One in three people with a chronic somatic disease suffer from a comorbid mental disorder. People with chronic diseases have to cope with many stressors, such as symptoms, treatment, role changes, relapse, uncertainty concerning the progression of their illness, and the threat of death. These patients have a significantly increased risk for developing mental disorders. Härter et al [4] reported a 12-month prevalence rate of 42.5 % for mental disorders in patients with chronic somatic diseases. Little epidemiologic data exists, adjustment disorders are among the most common mental disorders diagnosed in patients with chronic somatic diseases [5, 6]. Prevalence rates for adjustment disorders range from 7.1 % in patients with breast cancer [8] to 12 % in a consultation-liaison psychiatry service [9] and to 17 % in patients with cardiovascular diseases [10]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
