scholarly journals Temperament, character and personality disorders as predictors of response to interpersonal psychotherapy and cognitive-behavioural therapy for depression

2007 ◽  
Vol 190 (6) ◽  
pp. 503-508 ◽  
Author(s):  
Peter R. Joyce ◽  
Janice M. McKenzie ◽  
Janet D. Carter ◽  
Alma M. Rae ◽  
Suzanne E. Luty ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Personality Traits ◽  
Treatment Response ◽  
Cognitive Behavioural Therapy ◽  
Randomised Trial ◽  
Interpersonal Psychotherapy ◽  
Behavioural Therapy ◽  
Patient Treatment ◽  
Comparable Efficacy ◽  
Cognitive Behavioural

BackgroundInterpersonal psychotherapy and cognitive–behavioural therapy are widely accepted as effective treatments for major depression. There is little evidence on how personality disorder or personality traits affect treatment response.AimsTo determine whether personality disorder or traits have an adverse impact on treatment response to interpersonal psychotherapy or cognitive–behavioural therapy in people receiving out-patient treatment for depression.MethodThe study was a randomised trial in a university-based clinical research unit for out-patients with depression.ResultsPersonality disorder did not adversely affect treatment response for patients with depression randomised to cognitive–behavioural therapy Conversely, personality disorder did adversely affect treatment response for patients randomised to interpersonal psychotherapy.ConclusionsDespite the two therapies having comparable efficacy in patients with depression, response to interpersonal psychotherapy (but not cognitive–behavioural therapy) is affected by personality traits. This could suggest the two therapies are indicated for different patients or that they work by different mechanisms.

scholarly journals Comparison of brief dynamic and cognitive–behavioural therapies in avoidant personality disorder

2006 ◽  
Vol 189 (1) ◽  
pp. 60-64 ◽  
Author(s):  
Paul M. G. Emmelkamp ◽  
Ank Benner ◽  
Antoinette Kuipers ◽  
Guus A. Feiertag ◽  
Harrie C. Koster ◽  
...  
Keyword(s):  
Personality Disorder ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Waiting List ◽  
Patient Treatment ◽  
Control Group ◽  
Avoidant Personality Disorder ◽  
Dynamic Therapy ◽  
Cognitive Behavioural ◽  
Behavioural Therapies

BackgroundThere is a paucity of controlled trials examining the effectiveness of individual psychotherapy in personality disorders, especially in patients with cluster C disorders.AimsTo compare the effectiveness of brief dynamic therapy and cognitive–behavioural therapy as out-patient treatment for people with avoidant personality disorder.MethodPatients who met the criteria for avoidant personality disorder (n=62) were randomly assigned to 20 weekly sessions of either brief dynamic therapy (n=23) or cognitive–behavioural therapy (n=21), or they were assigned to the waiting-list control group (n=18). After the waiting period, patients in the control group were randomly assigned to one of the two therapies.ResultsPatients who received cognitive–behavioural therapy showed significantly more improvements on a number of measures in comparison with those who had brief dynamic psychotherapy or were in the waiting-list control group. Results were maintained at follow-up.ConclusionsCognitive–behavioural therapy is more effective than waiting-list control and brief dynamic therapy. Brief dynamic therapy was no better than the waiting-list control condition.

scholarly journals Randomised controlled trial of interpersonal psychotherapy and cognitive–behavioural therapy for depression

2007 ◽  
Vol 190 (6) ◽  
pp. 496-502 ◽  
Author(s):  
Suzanne E. Luty ◽  
Janet D. Carter ◽  
Janice M. McKenzie ◽  
Alma M. Rae ◽  
Christopher M. A. Frampton ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Rating Scale ◽  
Severe Depression ◽  
Interpersonal Psychotherapy ◽  
Behavioural Therapy ◽  
Patient Treatment ◽  
Melancholic Depression ◽  
Madrs Score ◽  
Cognitive Behavioural ◽  
Axis I

BackgroundInterpersonal psychotherapy and cognitive–behavioural therapy (CBT) are established as effective treatments for major depression. Controversy remains regarding their effectiveness for severe and melancholic depression.AimsTo compare the efficacy of interpersonal psychotherapy and CBT in people receiving out-patient treatment for depression and to explore response in severe depression (Montgomery–Åsberg Depression Rating Scale (MADRS) score above 30), and in melancholic depression.MethodRandomised clinical trial of 177 patients with a principal Axis I diagnosis of major depressive disorder receiving 16 weeks of therapy comprising 8–19 sessions. Primary outcome was improvement in MADRS score from baseline to end of treatment.ResultsThere was no difference between the two psychotherapies in the sample as a whole, but CBT was more effective than interpersonal psychotherapy in severe depression, and the response was comparable with that for mild and moder-ate depression. Melancholia did not predict poor response to either psychotherapy.ConclusionsBoth therapies are equally effective for depression but CBT maybe preferred in severe depression.

Psychological and other non-pharmacological approaches

2019 ◽  
pp. 74-84
Author(s):  
Navneet Kapur ◽  
Robert Goldney
Keyword(s):  
Borderline Personality Disorder ◽  
Personality Disorder ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Behaviour Therapy ◽  
Pharmacological Interventions ◽  
Interpersonal Therapy ◽  
Problem Solving Therapy ◽  
Cognitive Behavioural ◽  
Volunteer Organizations

This chapter discusses psychological and non-pharmacological interventions for suicidal behaviour in more detail. All people who present with suicidal thoughts and behaviour warrant some treatment, but the nature and intensity of this will depend on individual needs. Psychological treatments may include cognitive behavioural therapy, interpersonal therapy, problem-solving therapy, and mindfulness-based cognitive behavioural therapy. Dialectical behaviour therapy is specifically designed for those with a diagnosis of borderline personality disorder. Broader non-pharmacological approaches such as crisis centres, volunteer organizations, brief-contact interventions, and safety plans may be promising but require further research. Common therapeutic elements include a non-judgemental approach, empathy, respect, warmth, and genuineness.

scholarly journals Stepped care and cognitive–behavioural therapy for bulimia nervosa: randomised trial

2011 ◽  
Vol 198 (5) ◽  
pp. 391-397 ◽  
Author(s):  
James E. Mitchell ◽  
Stewart Agras ◽  
Scott Crow ◽  
Katherine Halmi ◽  
Christopher G. Fairburn ◽  
...  
Keyword(s):  
Bulimia Nervosa ◽  
Cognitive Behavioural Therapy ◽  
Relative Effectiveness ◽  
Randomised Trial ◽  
Behavioural Therapy ◽  
Individual Therapy ◽  
Stepped Care ◽  
Self Help ◽  
Treatment Conditions ◽  
Cognitive Behavioural

BackgroundThis study compared the best available treatment for bulimia nervosa, cognitive–behavioural therapy (CBT) augmented by fluoxetine if indicated, with a stepped-care treatment approach in order to enhance treatment effectiveness.AimsTo establish the relative effectiveness of these two approaches.MethodThis was a randomised trial conducted at four clinical centres (Clinicaltrials.gov registration number: NCT00733525). A total of 293 participants with bulimia nervosa were randomised to one of two treatment conditions: manual-based CBT delivered in an individual therapy format involving 20 sessions over 18 weeks and participants who were predicted to be non-responders after 6 sessions of CBT had fluoxetine added to treatment; or a stepped-care approach that began with supervised self-help, with the addition of fluoxetine in participants who were predicted to be non-responders after six sessions, followed by CBT for those who failed to achieve abstinence with self-help and medication management.ResultsBoth in the intent-to-treat and completer samples, there were no differences between the two treatment conditions in inducing recovery (no binge eating or purging behaviours for 28 days) or remission (no longer meeting DSM–IV criteria). At the end of 1-year follow-up, the stepped-care condition was significantly superior to CBT.ConclusionsTherapist-assisted self-help was an effective first-level treatment in the stepped-care sequence, and the full sequence was more effective than CBT suggesting that treatment is enhanced with a more individualised approach.

scholarly journals Protocol for a feasibility randomised trial of low-intensity interventions for antenatal depression: ADAGIO trial comparing interpersonal counselling with cognitive behavioural therapy

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e032649
Author(s):  
Jenny Ingram ◽  
Debbie Johnson ◽  
Sarah Johnson ◽  
Heather A O'Mahen ◽  
David Kessler ◽  
...  
Keyword(s):  
Cognitive Behavioural Therapy ◽  
Feasibility Study ◽  
Controlled Trial ◽  
Randomised Trial ◽  
Well Being ◽  
Behavioural Therapy ◽  
Advisory Group ◽  
Low Intensity ◽  
Cognitive Behavioural ◽  
Study Results

IntroductionOne in eight women suffer from depression during pregnancy. Currently, low-intensity brief treatment based on cognitive behavioural therapy (CBT) is the only talking treatment widely available in the National Health Service (NHS) for mild and moderate depression. CBT involves identifying and changing unhelpful negative thoughts and behaviours to improve mood. Mothers in our patient advisory groups requested greater treatment choice. Interpersonal counselling (IPC) is a low-intensity version of interpersonal therapy. It may have important advantages during pregnancy over CBT because it targets relationship problems, changes in role and previous losses (eg, miscarriage). We aim to compare CBT and IPC for pregnant women with depression in a feasibility study.Methods and analysisA two-arm non-blinded randomised feasibility study of 60 women will be conducted in two UK localities. Women with depression will be identified through midwife clinics and ultrasound scanning appointments and randomised to receive six sessions of IPC or CBT. In every other way, these women will receive usual care. Women thought to have severe depression will be referred for more intensive treatment. After 12 weeks, we will measure women’s mood, well-being, relationship satisfaction and use of healthcare. Women, their partners and staff providing treatments will be interviewed to understand whether IPC is an acceptable approach and whether changes should be introduced before applying to run a larger trial.Several groups of patients with depression during pregnancy have contributed to our study design. A patient advisory group will meet and advise us during the study.Ethics and disseminationStudy results will inform the design of a larger multicentre randomised controlled trial (RCT). Our findings will be shared through public engagement events, papers and reports to organisations within the NHS. National Research Ethics Service Committee approved the study protocol.Trial registration numberISRCTN11513120.

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