4.6 Article

Psychophysiological responses to group cognitive-behavioral therapy in depressive patients

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CURRENT PSYCHOLOGY
卷 42, 期 1, 页码 592-601

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SPRINGER
DOI: 10.1007/s12144-020-01324-9

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Cortisol; Sleep; Anxiety; Self-esteem; Open-label trial

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This study found that group-based Cognitive-Behavioral Therapy (gCBT) has significant effects in the treatment of mild-moderate Major Depressive Disorder (MDD). Patients showed reductions in depressive and anxiety symptoms, increased self-esteem and sleep quality after the treatment. The study also revealed that gCBT can regulate physiological responses and that these improvements were correlated with remission outcomes.
Cognitive-Behavioral Therapy (CBT) has a significant adjunctive effect in the treatment of Major Depressive Disorder (MDD), however its use as monotherapy in group-based approaches is less explored. We assessed the responses of distinct psychophysiological domains after a group-based CBT (gCBT, 16 weeks) intervention in drug-free patients with mild-moderate MDD (n = 20; women = 11) and compared them with a healthy control group (n = 25, women = 13). The treatment resulted in 65% of response and 55% of remission rates. Significant reductions in depressive and anxiety symptoms and increase in self-esteem and sleep quality were observed as gCBT responses. Moreover, after treatment, patients regulated their previously deregulated salivary cortisol awakening response and sleep quality toward healthy parameters. These improvements were correlated among themselves and dependent of remission outcome. Remitted patients showed larger improvements than non-remitted for all psychophysiological domains, except for serum cortisol that significantly changed only for no-remitted patients after gCBT but did not reached controls levels. Further, better baseline sleep quality was predictor of remission. The psychophysiological changes found support the use of gCBT as monotherapy treatment for mild-moderate MDD, corroborate the importance of the observation of the patients in theirs whole sociopsychophysiological condition since they are related to remission outcome and then stimulate further studies of validation of clinical protocols that work on all of these psychophysiological domains studied.

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