Cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy: results from a randomized controlled trial
Abstract Background Depressive and adjustment disorders are highly prevalent in patients with physical diseases and are associated with poorer quality of life, increased morbidity and mortality, as well as higher healthcare costs. Access to mental health care holds strong importance for these patien...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2017-10-01
|
| Series: | BMC Psychiatry |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12888-017-1494-9 |
| _version_ | 1817998575352676352 |
|---|---|
| author | Miriam Ruesch Almut Helmes Juergen Bengel |
| author_facet | Miriam Ruesch Almut Helmes Juergen Bengel |
| author_sort | Miriam Ruesch |
| collection | DOAJ |
| description | Abstract Background Depressive and adjustment disorders are highly prevalent in patients with physical diseases and are associated with poorer quality of life, increased morbidity and mortality, as well as higher healthcare costs. Access to mental health care holds strong importance for these patients, although waiting times for outpatient individual psychotherapy in Germany are often long. Attending an intervention while waiting for individual therapy could improve this problem. For this purpose, we developed an eight-session cognitive behavioral group therapy (STEpS) and tested its efficacy in a randomized controlled trial. Methods Seventy-six patients with chronic physical diseases and comorbid depressive or adjustment disorders were randomized to either STEpS or a waiting list control group. The primary outcome was self-reported depression measured by the Hospital Anxiety and Depression Scale (HADS-D), while the secondary outcomes included global psychological distress and health-related quality of life. Data was assessed at baseline, post-treatment and 2-month follow-up and was analyzed based on intention-to-treat. Results Compared to the control group, the STEpS group showed significantly less depression (d = 0.37; p = .009) and significantly higher quality of life (mental: d = 0.47; p = .030; physical: d = 0.70; p = .001) at post-treatment. The groups did not differ in global psychological distress. At 2-month follow-up, the STEpS group indicated significantly higher subjective physical health (d = 0.43; p = .046), but did not differ from the control group in the remaining outcomes. Conclusions STEpS proved effective in improving depression and health-related quality of life in the short term but did not reveal effects on mental outcomes at 2-month follow-up. Nonetheless, the implementation of STEpS as a waiting list intervention prior to individual therapy could help patients to handle long waiting periods in outpatient care. Trial registration German Clinical Trials Register DRKS00005140 (27 August 2013). |
| first_indexed | 2024-04-14T02:55:22Z |
| format | Article |
| id | doaj.art-143472c9a9494a0f970d404c461cce16 |
| institution | Directory Open Access Journal |
| issn | 1471-244X |
| language | English |
| last_indexed | 2024-04-14T02:55:22Z |
| publishDate | 2017-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Psychiatry |
| spelling | doaj.art-143472c9a9494a0f970d404c461cce162022-12-22T02:16:07ZengBMCBMC Psychiatry1471-244X2017-10-0117111310.1186/s12888-017-1494-9Cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy: results from a randomized controlled trialMiriam Ruesch0Almut Helmes1Juergen Bengel2Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University FreiburgDepartment of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University FreiburgDepartment of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University FreiburgAbstract Background Depressive and adjustment disorders are highly prevalent in patients with physical diseases and are associated with poorer quality of life, increased morbidity and mortality, as well as higher healthcare costs. Access to mental health care holds strong importance for these patients, although waiting times for outpatient individual psychotherapy in Germany are often long. Attending an intervention while waiting for individual therapy could improve this problem. For this purpose, we developed an eight-session cognitive behavioral group therapy (STEpS) and tested its efficacy in a randomized controlled trial. Methods Seventy-six patients with chronic physical diseases and comorbid depressive or adjustment disorders were randomized to either STEpS or a waiting list control group. The primary outcome was self-reported depression measured by the Hospital Anxiety and Depression Scale (HADS-D), while the secondary outcomes included global psychological distress and health-related quality of life. Data was assessed at baseline, post-treatment and 2-month follow-up and was analyzed based on intention-to-treat. Results Compared to the control group, the STEpS group showed significantly less depression (d = 0.37; p = .009) and significantly higher quality of life (mental: d = 0.47; p = .030; physical: d = 0.70; p = .001) at post-treatment. The groups did not differ in global psychological distress. At 2-month follow-up, the STEpS group indicated significantly higher subjective physical health (d = 0.43; p = .046), but did not differ from the control group in the remaining outcomes. Conclusions STEpS proved effective in improving depression and health-related quality of life in the short term but did not reveal effects on mental outcomes at 2-month follow-up. Nonetheless, the implementation of STEpS as a waiting list intervention prior to individual therapy could help patients to handle long waiting periods in outpatient care. Trial registration German Clinical Trials Register DRKS00005140 (27 August 2013).http://link.springer.com/article/10.1186/s12888-017-1494-9Waiting listsCognitive behavioral group therapyPhysical diseasesDepressionAdjustment disorders |
| spellingShingle | Miriam Ruesch Almut Helmes Juergen Bengel Cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy: results from a randomized controlled trial BMC Psychiatry Waiting lists Cognitive behavioral group therapy Physical diseases Depression Adjustment disorders |
| title | Cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy: results from a randomized controlled trial |
| title_full | Cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy: results from a randomized controlled trial |
| title_fullStr | Cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy: results from a randomized controlled trial |
| title_full_unstemmed | Cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy: results from a randomized controlled trial |
| title_short | Cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy: results from a randomized controlled trial |
| title_sort | cognitive behavioral group therapy for patients with physical diseases and comorbid depressive or adjustment disorders on a waiting list for individual therapy results from a randomized controlled trial |
| topic | Waiting lists Cognitive behavioral group therapy Physical diseases Depression Adjustment disorders |
| url | http://link.springer.com/article/10.1186/s12888-017-1494-9 |
| work_keys_str_mv | AT miriamruesch cognitivebehavioralgrouptherapyforpatientswithphysicaldiseasesandcomorbiddepressiveoradjustmentdisordersonawaitinglistforindividualtherapyresultsfromarandomizedcontrolledtrial AT almuthelmes cognitivebehavioralgrouptherapyforpatientswithphysicaldiseasesandcomorbiddepressiveoradjustmentdisordersonawaitinglistforindividualtherapyresultsfromarandomizedcontrolledtrial AT juergenbengel cognitivebehavioralgrouptherapyforpatientswithphysicaldiseasesandcomorbiddepressiveoradjustmentdisordersonawaitinglistforindividualtherapyresultsfromarandomizedcontrolledtrial |