Behavioural and cognitive psychotherapy · 2012
What predicts outcome, response, and drop-out in CBT of depressive adults? a naturalistic study.
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Schindler Amrei, Hiller Wolfgang, Witthöft Michael
Аннотация
BACKGROUND: The efficacy of CBT for unipolar depressive disorders is well established, yet not all patients improve or tolerate treatment.
AIMS: To identify factors associated with symptomatic outcome, response, and drop-out in depressive patients under naturalistic CBT.
METHOD: 193 patients with major depression or dysthymia were tested. Sociodemographic and clinical variables were entered as predictors in hierarchical regression analyses.
RESULTS: A higher degree of pretreatment depression, early improvement, and completion of therapy were identified as predictors for symptomatic change and response. Drop-out was predicted by concurrent personality disorder, less positive outcome expectancies, and by failure to improve early in treatment.
CONCLUSIONS: Our results highlight the importance of early response to predict improvement in routine CBT. Attempts to refine the quality of treatment programs should focus on avoiding premature termination (drop-out) and consider motivational factors in more depth. Routinely administered standardized assessments would enhance symptom monitoring and help to identify persons at risk of not improving under therapy.
AIMS: To identify factors associated with symptomatic outcome, response, and drop-out in depressive patients under naturalistic CBT.
METHOD: 193 patients with major depression or dysthymia were tested. Sociodemographic and clinical variables were entered as predictors in hierarchical regression analyses.
RESULTS: A higher degree of pretreatment depression, early improvement, and completion of therapy were identified as predictors for symptomatic change and response. Drop-out was predicted by concurrent personality disorder, less positive outcome expectancies, and by failure to improve early in treatment.
CONCLUSIONS: Our results highlight the importance of early response to predict improvement in routine CBT. Attempts to refine the quality of treatment programs should focus on avoiding premature termination (drop-out) and consider motivational factors in more depth. Routinely administered standardized assessments would enhance symptom monitoring and help to identify persons at risk of not improving under therapy.