Metacognitive Therapy for Depression Reduces Interpersonal Problems: Results From a Randomized Controlled Trial.

Eivind R Strand,Stian Solem,Odin Hjemdal,Leif E O Kennair,Roger Hagen

doi:10.3389/fpsyg.2018.01415

Eivind R Strand, Stian Solem + Show 3 more

Open Access

https://doi.org/10.3389/fpsyg.2018.01415

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Abstract

Interpersonal problems are significantly elevated in patients with depression. Metacognitive therapy (MCT) for depression does not address interpersonal problems but is associated with large reduction in depressive symptoms. The main aim of the current study was to explore whether MCT leads to improvements in interpersonal problems in patients with depression. The study was a waitlist controlled trial and assessments took place at pre- and post-treatment as well as 6-month follow-up. At pre-treatment, the sample had more interpersonal problems compared to samples from other studies of psychiatric outpatients. MCT was associated with large reductions in interpersonal problems. Level of interpersonal problems were not related to poorer treatment response. MCT, which does not directly target interpersonal problems, worked well for patients with depression and interpersonal problems. Future research should compare MCT with other evidence-based treatments for patients with depression and interpersonal problems.

Highlights

Interpersonal problems are common among patients with psychiatric disorders and especially patients with depression (Barrett and Barber, 2007; Bjerke et al, 2011)
The same observation was made in comparison with Norwegian outpatients at psychiatric clinics (M = 1.42, SD = 0.54) and scores from controls (M = 0.97, SD = 0.44) (Bjerke et al, 2011). These numbers indicate that the current depressed sample had more interpersonal problems compared to Norwegian controls (d = 1.58), outpatients referred to public mental health care (d = 0.37), as well as outpatients with obsessive–compulsive disorder (d = 0.70) (Solem et al, 2015)
Interpersonal problems were clearly present in the current sample of depressed patients and Metacognitive therapy (MCT) was an effective treatment for these problems

Summary

Introduction

Interpersonal problems are common among patients with psychiatric disorders and especially patients with depression (Barrett and Barber, 2007; Bjerke et al, 2011). Many patients show interpersonal rumination involving analyzing and anticipating distress in relational situations that could involve being offended, criticized, and humiliated (Ottavi et al, 2016). Treatment addressing such repetitive thinking in depression could be potentially beneficial and reduce interpersonal problems. Interpersonal problems are defined as unremitting difficulties experienced by individuals in their social relationships (Horowitz et al, 1988, 1993). For people struggling with major depressive disorder (MDD), interpersonal problems such as social difficulties and poor peer relationships seem to be present from early age (Lewinsohn et al, 2003). Interpersonal domains of distress have been found to predict recurrence of MDD over and above well-recognized depression risk factors such as dysfunctional cognitions and personality disorder symptoms in emerging adults (Sheets and Craighead, 2014)

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