Abstract
BackgroundThis naturalistic study examined the outcomes of Short-Term Schema Cognitive Behavioural Therapy in groups with personality disorders, and with high and low severity of depressive symptoms.MethodsAssessments were made at baseline, at mid-treatment (week 10), at treatment termination (week 20) and at three-month follow-up (week 32) of 225 patients with personality disorders and high severity of depressive symptoms (PD-Hi) and patients with low severity of depressive symptoms (PD-Lo). The assessments focused on symptom (Symptom Checklist-90) and schema severity (Young Schema Questionnaire) and coping styles (Utrecht Coping List). We also measured the rate of symptom remission. The data obtained were subjected to multilevel analysis.ResultsPsychiatric symptoms and maladaptive schemas improved in both patient groups. Effect sizes were moderate, and even small for the coping styles. Symptom remission was achieved in the minority of the total sample. Remission in psychiatric symptomatology was seen in more PD-Lo patients at treatment termination. However, the difference in levels of remission between the two patient groups was no longer apparent at follow-up.ConclusionA short-term form of schema therapy in groups proved to be an effective approach for a broad group of patients with personality disorders. However, the majority of patients did not achieve symptom remission.Trial registrationNot applicable.
Highlights
This naturalistic study examined the outcomes of Short-Term Schema Cognitive Behavioural Therapy in groups with personality disorders, and with high and low severity of depressive symptoms
We have found two naturalistic studies of effectiveness for personality disorders after a short form of group psychotherapy (20 sessions) in an outpatient setting: van Vreeswijk et al [11] and Renner et al [7] found a moderate (SCL-90-Global Severity Index (GSI); d = 0.66) and large effect size (SCL-90-GSI; d = 0.81) respectively
Most outcome studies of the treatment of personality disorders have failed to look at how comorbidity affects outcome, even though, in daily practice, many patients suffer from comorbid conditions, generally depressive disorders [12]
Summary
This naturalistic study examined the outcomes of Short-Term Schema Cognitive Behavioural Therapy in groups with personality disorders, and with high and low severity of depressive symptoms. Renner et al [14] found that patients with comorbid depression had more severe psychiatric and personality pathology at baseline and poorer treatment outcome after long-term individual schema therapy. This was not due to comorbid depression but to the significantly higher general psychiatric symptomatology at baseline in patients with a personality disorder and comorbid depression. This finding suggests that severe baseline psychiatric pathology could be a strong predictor of treatment outcome
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