Enhanced treatment for depression in primary care: long-term outcomes of a psycho-educational prevention program alone and enriched with psychiatric consultation or cognitive behavioral therapy

2007 ◽  
Vol 37 (6) ◽  
pp. 849-862 ◽  
Author(s):  
HENK JAN CONRADI ◽  
PETER de JONGE ◽  
HERMAN KLUITER ◽  
ANNET SMIT ◽  
KLAAS van der MEER ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Psychiatric Consultation ◽  
Term Outcome ◽  
Long Term Outcome

Background. The long-term outcome of major depression is often unfavorable, and because most cases of depression are managed by general practitioners (GPs), this places stress on the need to improve treatment in primary care. This study evaluated the long-term effects of enhancing the GP's usual care (UC) with three experimental interventions.Method. A randomized controlled trial was conducted from 1998 to 2003. The main inclusion criterion was receiving GP treatment for a depressive episode. We compared: (1) UC (n=72) with UC enhanced with: (2) a psycho-educational prevention (PEP) program (n=112); (3) psychiatrist-enhanced PEP (n=37); and (4) brief cognitive behavioral therapy followed by PEP (CBT-enhanced PEP) (n=44). We assessed depression status quarterly during a 3-year follow-up.Results. Pooled across groups, depressive disorder-free and symptom-free times during follow-up were 83% and 17% respectively. Almost 64% of the patients had a relapse or recurrence, the median time to recurrence was 96 weeks, and the mean Beck Depression Inventory (BDI) score over 12 follow-up assessments was 9·6. Unexpectedly, PEP patients had no better outcomes than UC patients. However, psychiatrist-enhanced PEP and CBT-enhanced PEP patients reported lower BDI severity during follow-up than UC patients [mean difference 2·07 (95% confidence interval (CI) 1·13–3·00) and 1·62 (95% CI 0·70–2·55) respectively] and PEP patients [2·37 (95% CI 1·35–3·39) and 1·93 (95% CI 0·92–2·94) respectively].Conclusions. The PEP program had no extra benefit compared to UC and may even worsen outcome in severely depressed patients. Enhancing treatment of depression in primary care with psychiatric consultation or brief CBT seems to improve the long-term outcome, but findings need replication as the interventions were combined with the ineffective PEP program.

scholarly journals 0361 LONG-TERM OUTCOME OF GROUP COGNITIVE-BEHAVIORAL THERAPY FOR INSOMNIA (CBT-I)

SLEEP ◽  
2017 ◽  
Vol 40 (suppl_1) ◽  
pp. A134-A134
Author(s):  
T Kuo ◽  
V Castronovo ◽  
L Giarolli ◽  
A Galbiati ◽  
M Sforza ◽  
...  
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Cognitive Behavioral ◽  
Term Outcome ◽  
Long Term Outcome

Five-year outcome of cognitive behavioral therapy and exposure with response prevention for bulimia nervosa

2010 ◽  
Vol 41 (5) ◽  
pp. 1061-1071 ◽  
Author(s):  
V. V. W. McIntosh ◽  
F. A. Carter ◽  
C. M. Bulik ◽  
C. M. A. Frampton ◽  
P. R. Joyce
Keyword(s):  
Cognitive Behavioral Therapy ◽  
Bulimia Nervosa ◽  
Relaxation Training ◽  
Behavioral Therapy ◽  
Response Prevention ◽  
Cognitive Behavioral ◽  
Term Outcome ◽  
Definition Of

BackgroundFew data exist examining the longer-term outcome of bulimia nervosa (BN) following treatment with cognitive behavioral therapy (CBT) and exposure with response prevention (ERP).MethodOne hundred and thirty-five women with purging BN received eight sessions of individual CBT and were then randomly assigned to either relaxation training (RELAX) or one of two ERP treatments, pre-binge (B-ERP) or pre-purge cues (P-ERP). Participants were assessed yearly following treatment and follow-up data were recorded.ResultsEighty-one per cent of the total sample attended long-term follow-up. At 5 years, abstinence rates from binging were significantly higher for the two exposure treatments (43% and 54%) than for relaxation (27%), with no difference between the two forms of exposure. Over 5 years, the frequency of purging was lower for the exposure treatments than for relaxation training. Rates of recovery varied according to definition of recovery. Recovery continued to increase to 5 years. At 5 years, 83% no longer met DSM-III-R criteria for BN, 65% received no eating disorder diagnosis, but only 36% had been abstinent from bulimic behaviors for the past year.ConclusionsThis study provides possible evidence of a conditioned inoculation from exposure treatment compared with relaxation training in long-term abstinence from binge eating at 5 years, and the frequency of purging over 5 years, but not for other features of BN. Differences among the groups were not found prior to 5 years. CBT is effective for BN, yet a substantial group remains unwell in the long term. Definition of recovery impacts markedly on recovery rates.

Long-Term Outcome of Psychodynamic Therapy and Cognitive-Behavioral Therapy in Social Anxiety Disorder

2014 ◽  
Vol 171 (10) ◽  
pp. 1074-1082 ◽  
Author(s):  
Falk Leichsenring ◽  
Simone Salzer ◽  
Manfred E. Beutel ◽  
Stephan Herpertz ◽  
Wolfgang Hiller ◽  
...  
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Cognitive Behavioral Therapy ◽  
Social Anxiety Disorder ◽  
Behavioral Therapy ◽  
Psychodynamic Therapy ◽  
Cognitive Behavioral ◽  
Term Outcome ◽  
Long Term Outcome

scholarly journals Long-term effects of Internet-delivered cognitive behavioral therapy for depression in primary care – the PRIM-NET controlled trial

2017 ◽  
Vol 35 (2) ◽  
pp. 126-136 ◽  
Author(s):  
Maria C. M. Eriksson ◽  
Marie Kivi ◽  
Dominique Hange ◽  
Eva-Lisa Petersson ◽  
Nashmil Ariai ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Behavioral Therapy ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Cognitive Behavioral ◽  
Long Term Effects

scholarly journals One-year randomized trial comparing virtual reality-assisted therapy to cognitive–behavioral therapy for patients with treatment-resistant schizophrenia

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Laura Dellazizzo ◽  
Stéphane Potvin ◽  
Kingsada Phraxayavong ◽  
Alexandre Dumais
Keyword(s):  
Virtual Reality ◽  
Cognitive Behavioral Therapy ◽  
Psychiatric Symptoms ◽  
Behavioral Therapy ◽  
Controlled Trial ◽  
Comparative Trial ◽  
Cognitive Behavioral ◽  
Treatment Resistant ◽  
Auditory Verbal Hallucinations

AbstractThe gold-standard cognitive–behavioral therapy (CBT) for psychosis offers at best modest effects. With advances in technology, virtual reality (VR) therapies for auditory verbal hallucinations (AVH), such as AVATAR therapy (AT) and VR-assisted therapy (VRT), are amid a new wave of relational approaches that may heighten effects. Prior trials have shown greater effects of these therapies on AVH up to a 24-week follow-up. However, no trial has compared them to a recommended active treatment with a 1-year follow-up. We performed a pilot randomized comparative trial evaluating the short- and long-term efficacy of VRT over CBT for patients with treatment-resistant schizophrenia. Patients were randomized to VRT (n = 37) or CBT (n = 37). Clinical assessments were administered before and after each intervention and at follow-up periods up to 12 months. Between and within-group changes in psychiatric symptoms were assessed using linear mixed-effects models. Short-term findings showed that both interventions produced significant improvements in AVH severity and depressive symptoms. Although results did not show a statistically significant superiority of VRT over CBT for AVH, VRT did achieve larger effects particularly on overall AVH (d = 1.080 for VRT and d = 0.555 for CBT). Furthermore, results suggested a superiority of VRT over CBT on affective symptoms. VRT also showed significant results on persecutory beliefs and quality of life. Effects were maintained up to the 1-year follow-up. VRT highlights the future of patient-tailored approaches that may show benefits over generic CBT for voices. A fully powered single-blind randomized controlled trial comparing VRT to CBT is underway.

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