One-year follow-up of a randomized trial with a dilemma-focused intervention for depression: Exploring an alternative to problem-oriented strategies
Cognitive behavioural therapy (CBT) is aimed to counteract cognitions and behaviours that are considered as dysfunctional. The aim of the study is to test whether the inclusion of a non-counteractive approach (dilemma-focused intervention, DFI) in combination with CBT group therapy will yield better...
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| Veröffentlicht in: | PloS one 2018-12, Vol.13 (12), p.e0208245-e0208245 |
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| creator | Feixas, Guillem Paz, Clara García-Grau, Eugeni Montesano, Adrián Medina, Joan C Bados, Arturo Trujillo, Adriana Ortíz, Eliana Compañ, Victoria Salla, Marta Aguilera, Mari Guasch, Víctor Codina, Jordi Winter, David A |
| description | Cognitive behavioural therapy (CBT) is aimed to counteract cognitions and behaviours that are considered as dysfunctional. The aim of the study is to test whether the inclusion of a non-counteractive approach (dilemma-focused intervention, DFI) in combination with CBT group therapy will yield better short- and long-term outcomes than an intervention conducted entirely using CBT.
A total of 128 patients with depression and at least one cognitive conflict, of six health community centres in Barcelona, participated from November of 2011 to December of 2014 in seven weekly group CBT sessions and were then randomly allocated to either DFI or CBT (eight individual sessions each) by an independent researcher. Depressive symptoms were assessed with the Beck Depression Inventory-II at baseline, at the end of therapy and three- and twelve-month follow-ups. Therapists did not participate in any of the assessments nor in the randomisation of patients and evaluators were masked to group assignment. Both intention to treat and complete case analyses were performed using linear mixed models with random effects.
According to intention-to-treat analysis (F2, 179 = 0.69) and complete case analysis (F2, 146 = 0.88), both conditions similarly reduced the severity of symptoms across posttreatment assessments. For the 77 participants (CBTgroup +CBTindividual = 40; CBTgroup+DFIindividual = 37) that completed allocated treatment and one-year follow-up assessment, response and remission rates were relative higher for the DFI condition, however no significant differences were found between treatment conditions. The relapse rates were similar between treatment conditions (CBTgroup +CBTindividual = 7/20; CBTgroup+DFIindividual = 8/22).
Although using a counteractive approach across all the treatment sessions is quite effective, it does not seem to be necessary to produce significant improvement. DFI may be considered as an alternative, which could be included in a wider treatment for depression.
ClinicalTrials.gov; ID: NCT01542957. |
| doi_str_mv | 10.1371/journal.pone.0208245 |
| format | Article |
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A total of 128 patients with depression and at least one cognitive conflict, of six health community centres in Barcelona, participated from November of 2011 to December of 2014 in seven weekly group CBT sessions and were then randomly allocated to either DFI or CBT (eight individual sessions each) by an independent researcher. Depressive symptoms were assessed with the Beck Depression Inventory-II at baseline, at the end of therapy and three- and twelve-month follow-ups. Therapists did not participate in any of the assessments nor in the randomisation of patients and evaluators were masked to group assignment. Both intention to treat and complete case analyses were performed using linear mixed models with random effects.
According to intention-to-treat analysis (F2, 179 = 0.69) and complete case analysis (F2, 146 = 0.88), both conditions similarly reduced the severity of symptoms across posttreatment assessments. For the 77 participants (CBTgroup +CBTindividual = 40; CBTgroup+DFIindividual = 37) that completed allocated treatment and one-year follow-up assessment, response and remission rates were relative higher for the DFI condition, however no significant differences were found between treatment conditions. The relapse rates were similar between treatment conditions (CBTgroup +CBTindividual = 7/20; CBTgroup+DFIindividual = 8/22).
Although using a counteractive approach across all the treatment sessions is quite effective, it does not seem to be necessary to produce significant improvement. DFI may be considered as an alternative, which could be included in a wider treatment for depression.
ClinicalTrials.gov; ID: NCT01542957.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0208245</identifier><identifier>PMID: 30543642</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adolescent ; Adult ; Aged ; Analysis ; Assessments ; Behavior modification ; Behavior therapy ; Behavioral medicine ; Biology and Life Sciences ; Care and treatment ; Clinical psychology ; Clinical trials ; Cognitive ability ; Cognitive Behavioral Therapy - methods ; Cognitive-behavioral therapy ; Community centers ; Community involvement ; Community participation ; Depresión mental ; Depression (Mood disorder) ; Depression - therapy ; Depression, Mental ; Depressió psíquica ; Female ; Follow-Up Studies ; Group counseling ; Health ; Health services ; Humans ; Internet ; Intervention ; Male ; Medical diagnosis ; Medicine and Health Sciences ; Mental depression ; Mental disorders ; Mental health ; Middle Aged ; Motivation ; Neurosciences ; Patients ; Personal construct theory ; Practice guidelines (Medicine) ; Psychobiology ; Psychotherapy ; Randomization ; Randomized Controlled Trials as Topic ; Remission ; Social Sciences ; Therapy ; Treatment Outcome ; Young Adult</subject><ispartof>PloS one, 2018-12, Vol.13 (12), p.e0208245-e0208245</ispartof><rights>COPYRIGHT 2018 Public Library of Science</rights><rights>2018 Feixas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>CC BY <a href="http://creativecommons.org/licenses/by/3.0/es/">http://creativecommons.org/licenses/by/3.0/es/</a></rights><rights>2018 Feixas et al 2018 Feixas et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c734t-5c9378bdabbc50d2551b00ec3b33200e91c3efe38835d7c3f2e5349f0e492ca43</citedby><cites>FETCH-LOGICAL-c734t-5c9378bdabbc50d2551b00ec3b33200e91c3efe38835d7c3f2e5349f0e492ca43</cites><orcidid>0000-0002-0160-3327 ; 0000-0003-1106-9567 ; 0000-0003-2656-2688 ; 0000-0003-0460-2925 ; 0000-0001-9201-8694</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292643/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6292643/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,315,728,781,785,865,886,2103,2929,23871,26979,27929,27930,53796,53798</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30543642$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>van Wouwe, Jacobus P.</contributor><creatorcontrib>Feixas, Guillem</creatorcontrib><creatorcontrib>Paz, Clara</creatorcontrib><creatorcontrib>García-Grau, Eugeni</creatorcontrib><creatorcontrib>Montesano, Adrián</creatorcontrib><creatorcontrib>Medina, Joan C</creatorcontrib><creatorcontrib>Bados, Arturo</creatorcontrib><creatorcontrib>Trujillo, Adriana</creatorcontrib><creatorcontrib>Ortíz, Eliana</creatorcontrib><creatorcontrib>Compañ, Victoria</creatorcontrib><creatorcontrib>Salla, Marta</creatorcontrib><creatorcontrib>Aguilera, Mari</creatorcontrib><creatorcontrib>Guasch, Víctor</creatorcontrib><creatorcontrib>Codina, Jordi</creatorcontrib><creatorcontrib>Winter, David A</creatorcontrib><title>One-year follow-up of a randomized trial with a dilemma-focused intervention for depression: Exploring an alternative to problem-oriented strategies</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Cognitive behavioural therapy (CBT) is aimed to counteract cognitions and behaviours that are considered as dysfunctional. The aim of the study is to test whether the inclusion of a non-counteractive approach (dilemma-focused intervention, DFI) in combination with CBT group therapy will yield better short- and long-term outcomes than an intervention conducted entirely using CBT.
A total of 128 patients with depression and at least one cognitive conflict, of six health community centres in Barcelona, participated from November of 2011 to December of 2014 in seven weekly group CBT sessions and were then randomly allocated to either DFI or CBT (eight individual sessions each) by an independent researcher. Depressive symptoms were assessed with the Beck Depression Inventory-II at baseline, at the end of therapy and three- and twelve-month follow-ups. Therapists did not participate in any of the assessments nor in the randomisation of patients and evaluators were masked to group assignment. Both intention to treat and complete case analyses were performed using linear mixed models with random effects.
According to intention-to-treat analysis (F2, 179 = 0.69) and complete case analysis (F2, 146 = 0.88), both conditions similarly reduced the severity of symptoms across posttreatment assessments. For the 77 participants (CBTgroup +CBTindividual = 40; CBTgroup+DFIindividual = 37) that completed allocated treatment and one-year follow-up assessment, response and remission rates were relative higher for the DFI condition, however no significant differences were found between treatment conditions. The relapse rates were similar between treatment conditions (CBTgroup +CBTindividual = 7/20; CBTgroup+DFIindividual = 8/22).
Although using a counteractive approach across all the treatment sessions is quite effective, it does not seem to be necessary to produce significant improvement. DFI may be considered as an alternative, which could be included in a wider treatment for depression.
ClinicalTrials.gov; ID: NCT01542957.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Analysis</subject><subject>Assessments</subject><subject>Behavior modification</subject><subject>Behavior therapy</subject><subject>Behavioral medicine</subject><subject>Biology and Life Sciences</subject><subject>Care and treatment</subject><subject>Clinical psychology</subject><subject>Clinical trials</subject><subject>Cognitive ability</subject><subject>Cognitive Behavioral Therapy - methods</subject><subject>Cognitive-behavioral therapy</subject><subject>Community centers</subject><subject>Community involvement</subject><subject>Community participation</subject><subject>Depresión mental</subject><subject>Depression (Mood disorder)</subject><subject>Depression - therapy</subject><subject>Depression, Mental</subject><subject>Depressió psíquica</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Group counseling</subject><subject>Health</subject><subject>Health services</subject><subject>Humans</subject><subject>Internet</subject><subject>Intervention</subject><subject>Male</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Mental depression</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Middle Aged</subject><subject>Motivation</subject><subject>Neurosciences</subject><subject>Patients</subject><subject>Personal construct theory</subject><subject>Practice guidelines (Medicine)</subject><subject>Psychobiology</subject><subject>Psychotherapy</subject><subject>Randomization</subject><subject>Randomized Controlled Trials as Topic</subject><subject>Remission</subject><subject>Social Sciences</subject><subject>Therapy</subject><subject>Treatment Outcome</subject><subject>Young 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Database</collection><collection>Materials Science Collection</collection><collection>Access via ProQuest (Open Access)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering Collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>Recercat</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Feixas, Guillem</au><au>Paz, Clara</au><au>García-Grau, Eugeni</au><au>Montesano, Adrián</au><au>Medina, Joan C</au><au>Bados, Arturo</au><au>Trujillo, Adriana</au><au>Ortíz, Eliana</au><au>Compañ, Victoria</au><au>Salla, Marta</au><au>Aguilera, Mari</au><au>Guasch, Víctor</au><au>Codina, Jordi</au><au>Winter, David A</au><au>van Wouwe, Jacobus P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>One-year follow-up of a randomized trial with a dilemma-focused intervention for depression: Exploring an alternative to problem-oriented strategies</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-12-13</date><risdate>2018</risdate><volume>13</volume><issue>12</issue><spage>e0208245</spage><epage>e0208245</epage><pages>e0208245-e0208245</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Cognitive behavioural therapy (CBT) is aimed to counteract cognitions and behaviours that are considered as dysfunctional. The aim of the study is to test whether the inclusion of a non-counteractive approach (dilemma-focused intervention, DFI) in combination with CBT group therapy will yield better short- and long-term outcomes than an intervention conducted entirely using CBT.
A total of 128 patients with depression and at least one cognitive conflict, of six health community centres in Barcelona, participated from November of 2011 to December of 2014 in seven weekly group CBT sessions and were then randomly allocated to either DFI or CBT (eight individual sessions each) by an independent researcher. Depressive symptoms were assessed with the Beck Depression Inventory-II at baseline, at the end of therapy and three- and twelve-month follow-ups. Therapists did not participate in any of the assessments nor in the randomisation of patients and evaluators were masked to group assignment. Both intention to treat and complete case analyses were performed using linear mixed models with random effects.
According to intention-to-treat analysis (F2, 179 = 0.69) and complete case analysis (F2, 146 = 0.88), both conditions similarly reduced the severity of symptoms across posttreatment assessments. For the 77 participants (CBTgroup +CBTindividual = 40; CBTgroup+DFIindividual = 37) that completed allocated treatment and one-year follow-up assessment, response and remission rates were relative higher for the DFI condition, however no significant differences were found between treatment conditions. The relapse rates were similar between treatment conditions (CBTgroup +CBTindividual = 7/20; CBTgroup+DFIindividual = 8/22).
Although using a counteractive approach across all the treatment sessions is quite effective, it does not seem to be necessary to produce significant improvement. DFI may be considered as an alternative, which could be included in a wider treatment for depression.
ClinicalTrials.gov; ID: NCT01542957.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30543642</pmid><doi>10.1371/journal.pone.0208245</doi><tpages>e0208245</tpages><orcidid>https://orcid.org/0000-0002-0160-3327</orcidid><orcidid>https://orcid.org/0000-0003-1106-9567</orcidid><orcidid>https://orcid.org/0000-0003-2656-2688</orcidid><orcidid>https://orcid.org/0000-0003-0460-2925</orcidid><orcidid>https://orcid.org/0000-0001-9201-8694</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2018-12, Vol.13 (12), p.e0208245-e0208245 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2155918359 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); Recercat; PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Adolescent Adult Aged Analysis Assessments Behavior modification Behavior therapy Behavioral medicine Biology and Life Sciences Care and treatment Clinical psychology Clinical trials Cognitive ability Cognitive Behavioral Therapy - methods Cognitive-behavioral therapy Community centers Community involvement Community participation Depresión mental Depression (Mood disorder) Depression - therapy Depression, Mental Depressió psíquica Female Follow-Up Studies Group counseling Health Health services Humans Internet Intervention Male Medical diagnosis Medicine and Health Sciences Mental depression Mental disorders Mental health Middle Aged Motivation Neurosciences Patients Personal construct theory Practice guidelines (Medicine) Psychobiology Psychotherapy Randomization Randomized Controlled Trials as Topic Remission Social Sciences Therapy Treatment Outcome Young Adult |
| title | One-year follow-up of a randomized trial with a dilemma-focused intervention for depression: Exploring an alternative to problem-oriented strategies |
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