PMID- 25240140
OWN - NLM
STAT- MEDLINE
DCOM- 20150810
LR  - 20181202
IS  - 1573-2517 (Electronic)
IS  - 0165-0327 (Linking)
VI  - 170
DP  - 2015 Jan 1
TI  - Therapist-rated outcomes in a randomized clinical trial comparing cognitive 
      behavioral therapy and psychodynamic therapy for major depression.
PG  - 112-8
LID - S0165-0327(14)00512-6 [pii]
LID - 10.1016/j.jad.2014.08.023 [doi]
AB  - BACKGROUND: The efficacy of psychodynamic therapy (PDT) for depression is debated 
      due to a paucity of high-quality studies. We compared short psychodynamic 
      supportive psychotherapy (SPSP) to cognitive behavioral therapy (CBT) in a 
      randomized clinical trial. We used therapist-rated outcomes to examine how the 
      course of change during treatment could be best represented and to compare 
      treatment efficacy, hypothesizing non-significant differences. METHODS: Three 
      hundred and forty-one adults meeting DSM-IV criteria for a depressive episode and 
      with Hamilton Depression Rating Scale (HAM-D) scores >/=14 were randomized to 16 
      sessions of individual manualized CBT or SPSP. Severely depressed patients 
      (HAM-D>24) received additional antidepressant medication. After each session, 
      therapists rated the Clinical Global Impression Scale subscales 'Severity of 
      Illness' (CGI-S) and 'Global Improvement' (CGI-I), and the DSM-IV Axis V Global 
      Assessment of Functioning Scale (GAF). We fitted growth curves using mixed model 
      analyses with intention-to-treat samples. RESULTS: CGI-S and GAF scores during 
      treatment were best represented by a linear symptom decrease. CGI-I scores were 
      best represented by an S-shaped curve with relative more improvement in the first 
      and last phases than in the middle phase of treatment. No significant 
      post-treatment treatment differences were found. A non-significant trend for a 
      treatment effect on CGI-S scores vanished when controlling for therapist gender 
      and profession. LIMITATIONS: Therapists were not specifically trained for CGI and 
      GAF assessments. CONCLUSIONS: These findings add to the evidence-base of PDT for 
      depression. Therapist characteristics and differences between severity and 
      improvement measures might influence ratings and need to be taken into account 
      when using therapist-rated outcome measures.
CI  - Copyright (c) 2014 Elsevier B.V. All rights reserved.
FAU - Driessen, Ellen
AU  - Driessen E
AD  - VU University Amsterdam, Department of Clinical Psychology, Amsterdam, The 
      Netherlands; EMGO Institute for Health and Care Research, VU University and VU 
      University Medical Center Amsterdam, The Netherlands. Electronic address: 
      e.driessen@vu.nl.
FAU - Van Henricus, L
AU  - Van Henricus L
AD  - Arkin Mental Health Care, Amsterdam, The Netherlands.
FAU - Peen, Jaap
AU  - Peen J
AD  - Arkin Mental Health Care, Amsterdam, The Netherlands.
FAU - Don, Frank J
AU  - Don FJ
AD  - Arkin Mental Health Care, Amsterdam, The Netherlands; ProPersona Mental Health, 
      Nijmegen, The Netherlands.
FAU - Kool, Simone
AU  - Kool S
AD  - Arkin Mental Health Care, Amsterdam, The Netherlands.
FAU - Westra, Dieuwertje
AU  - Westra D
AD  - Arkin Mental Health Care, Amsterdam, The Netherlands.
FAU - Hendriksen, Marielle
AU  - Hendriksen M
AD  - Arkin Mental Health Care, Amsterdam, The Netherlands.
FAU - Cuijpers, Pim
AU  - Cuijpers P
AD  - VU University Amsterdam, Department of Clinical Psychology, Amsterdam, The 
      Netherlands; EMGO Institute for Health and Care Research, VU University and VU 
      University Medical Center Amsterdam, The Netherlands.
FAU - Twisk, Jos W R
AU  - Twisk JW
AD  - VU University Amsterdam, Department of Health Sciences, Amsterdam, The 
      Netherlands; VU University Medical Center Amsterdam, Department of Epidemiology 
      and Biostatistics, Amsterdam, The Netherlands.
FAU - Dekker, Jack J M
AU  - Dekker JJ
AD  - VU University Amsterdam, Department of Clinical Psychology, Amsterdam, The 
      Netherlands; EMGO Institute for Health and Care Research, VU University and VU 
      University Medical Center Amsterdam, The Netherlands; Arkin Mental Health Care, 
      Amsterdam, The Netherlands.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20140828
PL  - Netherlands
TA  - J Affect Disord
JT  - Journal of affective disorders
JID - 7906073
SB  - IM
MH  - Adult
MH  - *Cognitive Behavioral Therapy
MH  - Depressive Disorder, Major/psychology/*therapy
MH  - Diagnostic and Statistical Manual of Mental Disorders
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Psychotherapy, Brief
MH  - *Psychotherapy, Psychodynamic
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Cognitive behavioral therapy
OT  - Depression
OT  - Efficacy
OT  - Psychodynamic therapy
OT  - Psychotherapy
OT  - Therapist-rated outcomes
EDAT- 2014/09/23 06:00
MHDA- 2015/08/11 06:00
CRDT- 2014/09/21 06:00
PHST- 2014/03/19 00:00 [received]
PHST- 2014/08/13 00:00 [revised]
PHST- 2014/08/15 00:00 [accepted]
PHST- 2014/09/21 06:00 [entrez]
PHST- 2014/09/23 06:00 [pubmed]
PHST- 2015/08/11 06:00 [medline]
AID - S0165-0327(14)00512-6 [pii]
AID - 10.1016/j.jad.2014.08.023 [doi]
PST - ppublish
SO  - J Affect Disord. 2015 Jan 1;170:112-8. doi: 10.1016/j.jad.2014.08.023. Epub 2014 
      Aug 28.