scholarly journals Baseline imbalance about depressive symptoms may overestimate the effectiveness of mindfulness-based cognitive therapy for anxiety disorders.

Author(s):  
Takuya Oka ◽  
Jun Watanabe ◽  
Yasushi Tsujimoto

We read the article by Ninomiya et al. with great interest and appreciate the author's efforts to analyze the effect of primary mindfulness-based cognitive therapy (MBCT) in patients with anxiety disorder in secondary-care settings, compared with a waiting-list group. However, we have concerns about baseline imbalance of depressive symptoms that may influence the conclusion of the trial. Comorbid major depressive disorder can have caused an underestimation of anxiety symptoms in the waiting-list group and distort effectiveness of MBCT. The wait-list group had more severe depressive symptoms than the intervention group, about 7 points more in the Center for Epidemiologic Studies Depression Scale (CES-D) scores, and that group might have more major depressive disorder. Indeed, the rate of antidepressant use in the wait-list group was 25% higher than the intervention group. It is well known that major depressive disorder is associated with cognitive errors and underestimation of self-report outcomes. Baseline imbalance of depressive symptoms may therefore weaken the conclusion of the study, because all outcome measures were self-report questionnaires. The authors should acknowledge the limitation and provide information about the diagnosis of major depressive disorder.

1984 ◽  
Vol 144 (4) ◽  
pp. 400-406 ◽  
Author(s):  
John D. Teasdale ◽  
Melanie J. V. Fennell ◽  
George A. Hibbert ◽  
Peter L Amies

SummaryCognitive therapy for depression is a psychological treatment designed to train patients to identify and correct the negative depressive thinking which, it has been hypothesised, contributes to the maintenance of depression. General practice patients meeting Research Diagnostic Criteria for primary major depressive disorder were randomly allocated either to continue with the treatment they would normally receive (which in the majority of cases included antidepressant medication) or to receive, in addition, sessions of cognitive therapy. At completion of treatment, patients receiving cognitive therapy were significantly less depressed than the comparison group, both on blind ratings of symptom severity made by psychiatric assessors and on a self-report measure of severity of depression. At three-month follow-up cognitive therapy patients no longer differed from patients receiving treatment-as-usual, but this was mainly as a result of continuing improvement in the comparison group.


CNS Spectrums ◽  
2010 ◽  
Vol 15 (6) ◽  
pp. 367-373 ◽  
Author(s):  
Ira H. Bernstein ◽  
A. John Rush ◽  
Trisha Suppes ◽  
Yakasushi Kyotoku ◽  
Diane Warden

ABSTRACTIntroduction: The clinical and self-report versions of the Quick Inventory of Depressive Symptomatology (QIDS-C16 and QIDS-SR16) have been well studied in patients with major depressive disorder and in one recent study using patients with bipolar disorder. This article examines these measures in a second sample of 141 outpatients with bipolar disorder in different phases of the illness.Methods: At baseline, 61 patients were depressed and 30 were euthymic; at exit, 50 were depressed and 52 were euthymic. The remaining patients (at baseline or exit) were in either a manic or mixed phase and were pooled for statistical reasons.Results: Similar results were found for the QIDS-C16 and QIDS-SR16. Scores were reasonably reliable to the extent that variability within groups permitted. As expected, euthymic patients showed less depressive symptomatology than depressed patients. Sad mood and general interest were tne most discriminating symptoms between depressed and euthymic phases. Changes in illness phase (baseline to exit) were associated with substantial changes in scores. The relation of individual depressive symptoms to the overall level of depression was consistent across phases.Conclusion: Both the QIDS-SR16 and QIDS-C16 are suitable measures of depressive symptoms in patients with bipolar disorder.


2020 ◽  
Author(s):  
Nicole Geschwind ◽  
Martijn van Teffelen ◽  
Elin Hammarberg ◽  
Arnoud Arntz ◽  
M.J.H. Huibers ◽  
...  

Background: Previous research suggests a relationship between measurement frequency of self-reported depressive symptoms and change in depressive symptom scores for the Beck Depression Inventory II (BDI-II). The goal of the current study was to investigate the differential effects of weekly and monthly completion of the BDI-II and Quick Inventory of Depressive Symptomatology self-report (QIDS-SR). Methods: Seventy individuals diagnosed with major depressive disorder (MDD) waiting for treatment were randomly assigned to either completing BDI-II weekly, BDI-II monthly, QIDS-SR weekly, or QIDS-SR monthly for a duration of nine weeks. After nine weeks participants also completed the Zung depression scale once. Mixed multilevel regression modelling and Bayesian Statistical Analysis were used to test the relationship between the measurement frequency and depression scores, and to compare scores of the repeatedly completed instruments with the instrument completed only in week nine.Results: Measurement frequency was not related to BDI-II, QIDS-SR or Zung scores. However, depression scores declined in the weekly and monthly QIDS-SR (but not BDI-II) conditions, while Bayesian analyses indicated moderate support for equal depression scores on the Zung SDS.Limitations: Lack of a clinician-rated depression scale at week nine in addition to the self-report measure. Conclusion: In contrast to previous studies in non-clinical samples, our findings suggest that measurement frequency does not have an impact on scores of the BDI-II. Implications for clinical studies monitoring depressive symptom scores with self-report scales are discussed. Keywords: major depressive disorder; retest effects; measurement error; measurement frequency; Beck Depression Inventory; Quick Inventory of Depressive Symptomatology


1993 ◽  
Vol 163 (3) ◽  
pp. 369-374 ◽  
Author(s):  
Peter J. Cooper ◽  
Ian Goodyer

A community study was conducted to determine the prevalence of depressive symptoms and syndromes in 11–16-year-old girls. Girls from three secondary schools (1072 girls in total) were administered questionnaires and 375 were selected for direct interview. The estimated prevalence for current major depressive disorder (within the past month) for the population was 3.6%, and for the past year was 6.0%. Scores on the self-report questionnaire of mood disturbance increased with age, as did the prevalence of depressive disorder. A large proportion of interviewed girls reported depressive symptoms which did not meet the DSM-III-R criteria for major depressive disorder. The estimated prevalence of this ‘partial syndrome’ group was 8.9% for a current episode and 20.7% for the past year.


2015 ◽  
Vol 45 (15) ◽  
pp. 3191-3204 ◽  
Author(s):  
J. R. Vittengl ◽  
L. A. Clark ◽  
M. E. Thase ◽  
R. B. Jarrett

Background.The cognitive model of depression suggests that cognitive therapy (CT) improves major depressive disorder (MDD) in part by changing depressive cognitive content (e.g. dysfunctional attitudes, hopelessness). The current analyses clarified: (1) the durability of improvements in cognitive content made by acute-phase CT responders; (2) whether continuation-phase CT (C-CT) or fluoxetine (FLX) further improves cognitive content; and (3) the extent to which cognitive content mediates continuation treatments’ effects on depressive symptoms and major depressive relapse/recurrence.Method.Out-patients with recurrent MDD who responded to acute-phase CT (n = 241) were randomized to 8 months of C-CT, FLX or pill placebo (PBO) and followed for an 24 additional months. Cognitive content was assessed approximately every 4 months using five standard patient-report measures.Results.Large improvements in cognitive content made during acute-phase CT were maintained for 32 months, with 78–90% of patients scoring in normal ranges, on average. Cognitive content varied little between C-CT, FLX and PBO arms, overall. Small, transient improvements in cognitive content in C-CT or FLX compared with PBO patients did not clearly mediate the treatments’ effects on depressive symptoms or on major depressive relapse/recurrence.Conclusions.Outpatients with recurrent MDD who respond to acute-phase CT show durable improvements in cognitive content. C-CT or FLX may not continue to improve patient-reported cognitive content substantively, and thus may treat recurrent MDD by other paths.


BJPsych Open ◽  
2020 ◽  
Vol 6 (6) ◽  
Author(s):  
Dirk E.M. Geurts ◽  
Felix R. Compen ◽  
Marleen H.C.T. Van Beek ◽  
Anne E.M. Speckens

Background Meta-analyses show efficacy of mindfulness-based cognitive therapy (MBCT) in terms of relapse prevention and depressive symptom reduction in patients with major depressive disorder (MDD). However, most studies have been conducted in controlled research settings. Aims We aimed to investigate the effectiveness of MBCT in patients with MDD presenting in real-world clinical practice. Moreover, we assessed whether guideline recommendations for MBCT allocation in regard to recurrence and remission status of MDD hold in clinical practice. Method This study assessed a naturalistic cohort of patients with (recurrent) MDD, either current or in remission (n = 765), who received MBCT in a university hospital out-patient clinic in The Netherlands. Outcome measures were self-reported depressive symptoms, worry, mindfulness skills and self-compassion. Predictors were MDD recurrence and remission status, and clinical and sociodemographic variables. Outcome and predictor analyses were conducted with linear regression. Results MBCT adherence was high (94%). Patients with a lower level of education had a higher chance of non-adherence. Attending more sessions positively influenced improvement in depressive symptoms. Depressive symptoms significantly reduced from pre- to post-MBCT (Δ mean = 7.7, 95%CI = 7.0–8.5, Cohen's d = 0.75). Improvement of depressive symptoms was independent from MDD recurrence and remission status. Unemployed patients showed less favourable outcomes. Worry, mindfulness skills and self-compassion all significantly improved. These improvements were related to changes in depressive symptoms. Conclusions Previous efficacy results in controlled research settings are maintained in clinical practice. Results illustrate that MBCT is effective in routine clinical practice for patients suffering from MDD, irrespective of MDD recurrence and remission status.


2020 ◽  
Vol 26 (1) ◽  
pp. 11-20
Author(s):  
Catherine Jefferson VanDerwerker ◽  
Yue Cao ◽  
Chris M. Gregory ◽  
James S. Krause

Background: In neurologically healthy individuals, exercise positively impacts depressive symptoms, but there is limited knowledge regarding the association between exercise behaviors and depression after spinal cord injury (SCI). Objective: To examine associations between doing planned exercise and probable major depressive disorder (PMDD) after SCI. Methods: Community-dwelling adults, who were one or more years post traumatic SCI, completed self-report assessments at baseline (Time 1) and an average of 3.29 years later (Time 2). Patient Health Questionnaire-9 was used to assess depressive symptoms. Participants self-reported frequency of doing planned exercise. There were 1,790 participants who responded at both Time 1 and 2. Associations were analyzed using logistic regression. Results: Prevalence of PMDD was 10% at Time 1 and 12% at Time 2. Only 34% of participants at Time 1 and 29% at Time 2 reported doing planned exercise three or more times per week. The majority of participants (47%) reported no change in frequency of doing planned exercise between Times 1 and 2. Significant risk factors for PMDD at Time 2 included low household income ( p = .0085), poor to fair self-perceived health ( p < .0001), and doing less planned exercise at Time 2 ( p = .0005). Meanwhile, number of years post injury ( p = .04), doing planned exercise three or more times per week at Time 1 ( p = .0042), and doing more planned exercise at Time 2 ( p = .0005) were associated with decreased odds of PMDD at Time 2. Conclusion: These results demonstrate that a negative association exists between doing planned exercise and PMDD post SCI. Future longitudinal studies are needed to further explain these findings.


2021 ◽  
Vol 11 (1) ◽  
pp. 8
Author(s):  
Carol S. North ◽  
David Baron

Agreement has not been achieved across symptom factor studies of major depressive disorder, and no studies have identified characteristic postdisaster depressive symptom structures. This study examined the symptom structure of major depression across two databases of 1181 survivors of 11 disasters studied using consistent research methods and full diagnostic assessment, addressing limitations of prior self-report symptom-scale studies. The sample included 808 directly-exposed survivors of 10 disasters assessed 1–6 months post disaster and 373 employees of 8 organizations affected by the September 11, 2001 terrorist attacks assessed nearly 3 years after the attacks. Consistent symptom patterns identifying postdisaster major depression were not found across the 2 databases, and database factor analyses suggested a cohesive grouping of depression symptoms. In conclusion, this study did not find symptom clusters identifying postdisaster major depression to guide the construction and validation of screeners for this disorder. A full diagnostic assessment for identification of postdisaster major depressive disorder remains necessary.


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