Abstract
Background: This study explores the association of experienced dependency in psychotherapy as measured with the CDQ (Care Dependency Questionnaire) and treatment outcome in depression. Furthermore, the course of care dependency and differences in the CDQ scores depending on the received type of treatment, MCT (metacognitive therapy), or CBASP (cognitive behavioral analysis system of psychotherapy), were investigated.Methods: The study follows a prospective, parallel group observational design. Patients suffering from depression received an 8-week intensive day clinic program, which was either CBASP or MCT. The treatment decision was made by clinicians based on the presented symptomatology and with regard to the patients' preferences. The patients reported depressive symptoms with the QIDS-SR16 (Quick Inventory of Depressive Symptomatology) and levels of experienced care dependency with the German version of the CDQ on a weekly basis. Mixed-model analyses were run to account for the repeated-measures design.Results: One hundred patients were included in the analyses. Results indicate that higher levels of care dependency might predict a less favorable outcome of depressive symptomatology. Levels of care dependency as well as depressive symptoms decreased significantly over the course of treatment. There was no significant between-group difference in care dependency between the two treatment groups.Conclusion: The results suggest that care dependency might be associated with a worse treatment outcome in depressed patients. In general, care dependency seems to be a dynamic construct, as it is changing over time, while the levels of care dependency seem to be independent from the received type of treatment. Future research should continue investigating the mechanisms of care dependency in a randomized controlled design.Clinical Trial Registration: https://www.drks.de/drks_web/, identifier: DRKS00023779.
Highlights
Dependency from another is a natural phenomenon that can be found in many species, especially in humans
Care Dependency as a Predictor for Symptomatic Development in Depressed Patients Taking the results of the main analysis into consideration, we found hints that aspects of care dependency might serve as potential predictors with regard to the development of depressive symptoms
For all analyses across all datasets, we found a positive direction of effects, which allows the assumption that a higher degree of experienced care dependency is associated with a higher degree of depressive symptomatology at the end of treatment
Summary
Dependency from another is a natural phenomenon that can be found in many species, especially in humans. As described above, a certain degree of dependency seems to be indispensable in living an autonomous life that is accompanied by spontaneous actions of the individual. Considering that therapist and patient spend a considerable amount of time together with the patient opening up about sensitive topics, the question arises whether dependency may evolve in psychotherapy as well and how it may affect the outcome of treatment. This study explores the association of experienced dependency in psychotherapy as measured with the CDQ (Care Dependency Questionnaire) and treatment outcome in depression. The course of care dependency and differences in the CDQ scores depending on the received type of treatment, MCT (metacognitive therapy), or CBASP (cognitive behavioral analysis system of psychotherapy), were investigated
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