期刊
NORDIC JOURNAL OF PSYCHIATRY
卷 71, 期 6, 页码 465-472出版社
TAYLOR & FRANCIS LTD
DOI: 10.1080/08039488.2017.1331263
关键词
Cognitive behaviour therapy; group therapy; interdisciplinary rehabilitation; treatment-resistant depression; psychiatric comorbidity; efficacy; follow-up
类别
资金
- Reykjalundur Research Fund
Background: Cognitive behaviour therapy (CBT) has been shown to be effective, yet there is a paucity of research on the differential effectiveness of individual and group CBT for adults with treatment-resistant depression with psychiatric comorbidity.Aims: To investigate the effectiveness of individual and group CBT for inpatients, in an interdisciplinary rehabilitation setting; the extent of psychiatric comorbidity; and who benefits the most from group CBT.Methods: All patients (n=181) received 6 weeks of rehabilitation (treatment as usual, TAU). In addition, they were randomly allocated to group CBT (n=86) or individual CBT (n=59) combined with TAU, or TAU only (n=36). All CBT therapists were part of an interdisciplinary team, had at least 1-year CBT training, and attended weekly supervision. The same CBT manual was used for individual and group therapy, providing 12 sessions, two per week. Groups had 12-15 participants and two therapists in each session.Results: Individual CBT was superior in efficacy to group CBT and TAU, with a large within-subject effect size (ES=2.10). Group CBT was not superior to TAU. The benefits of treatment decreased over time, but remained large at 18-month follow-up for individual CBT (ES=1.02), and medium for group CBT (ES=0.46) and TAU (ES=0.60).Conclusions: Individual CBT was an effective addition to TAU and showed significant improvements in symptom severity post-treatment and at 18-month follow-up. Disorder severity and comorbidity may have decreased effectiveness of group therapy primarily aimed at depression.
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