Differentiating early-onset chronic depression from episodic depression in terms of cognitive-behavioral and emotional avoidance

Brockmeyer, Timo; Kulessa, Dominika; Hautzinger, Martin; Bents, Hinrich; Backenstraß, Matthias

doi:10.1016/j.jad.2015.01.045

Cited by 34 publications

(29 citation statements)

References 48 publications

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“…Of 20 studies that compared the educational level between CD and non‐CD patients 16 studies showed a similar level of education for both groups (Angst et al., ; Brockmeyer, Kulessa, Hautzinger, Bents, & Backenstrass, ; Garyfallos et al., ; D. N. Klein et al., , , , ; J. P. Klein et al., ; Köhler et al., ; Leader & Klein, ; Ley et al., ; Lizardi et al., ; Murphy & Byrne, ; Szadoczky et al., ; Wiersma et al., , ). In contrast, four studies found a lower level of education in CD patients versus non‐CD patients with little but significant differences regarding the education years between both groups (Gilmer et al., ; Ildirli, Sair, & Dereboy, ; Satyanarayana et al., ; Sung et al., ).…”

Section: Resultsmentioning

confidence: 99%

“…Twenty‐one studies gathered data concerning psychiatric comorbidities between both groups (Angst et al., ; Brockmeyer et al., ; Garyfallos et al., ; Gilmer et al., ; Hays et al., ; Ildirli et al., ; D. N. Klein et al., , , , ; J. P. Klein et al., ; Köhler et al., ; Ley et al., ; Murphy & Byrne, ; Riso et al., ; Satyanarayana et al., ; Sung et al., ; Szadoczky et al., ; van Randenborgh et al., ; Wiersma et al., , ). Thirteen studies found higher rates of axis I disorders (Angst et al., ; Gilmer et al., ; Ildirli et al., ; D. N. Klein et al., , , , ; Murphy & Byrne, ; Satyanarayana et al., ; Sung et al., ; van Randenborgh et al., ; Wiersma et al., , ).…”

Section: Resultsmentioning

confidence: 99%

“…() found very similar results with the higher scores of HDRS in the CD group (mean = 20.46, SD = 5.19) compared to non‐CD patients (mean = 16.69 – 14.67, SD = 4.83 – 4.32). Nine studies found no differences in symptom severity between CD and non‐CD (Brockmeyer et al., ; Gilmer et al., ; Hays et al., ; J. P. Klein et al., ; Ley et al., ; Rush et al., ; Sung et al., ; Szadoczky et al., ; van Randenborgh et al., ) and three studies even found higher scores of symptom severity in non‐CD patients (Ildirli et al., ; D. N. Klein et al., , ).…”

Section: Resultsmentioning

confidence: 99%

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Differences between chronic and nonchronic depression: Systematic review and implications for treatment

et al. 2018

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Background: There is still uncertainty if and to what extent chronic depression (CD) presents with specific features especially in contrast to the nonchronic course of major depressive disorder (non-CD). This systematic review aims to summarize the existing literature regarding sociodemographic factors, psychopathology, and course of disease in patients with CD in comparison to patients with non-CD. Methods: A structured database search (MEDLINE, PsycINFO, Web of Science, CENTRAL) was performed. All studies comparing CD with non-CD patients were included. Twenty-eight studies, including cohort studies, cross-sectional studies, and observational studies, were identified in which both subgroups were diagnosed according to DSM-IV or DSM-5, respectively. Primary outcome were group comparisons focused on sociodemographic factors, childhood adversity, onset of the disorder, comorbidities, severity and course of the depressive symptoms, and specific psychopathology.Results: Patients with CD had an earlier onset of depressive symptoms, higher rates of psychiatric comorbidities, and a complicated treatment course (e.g., higher rates of suicidality) compared to non-CD. We also found some evidence for specific features in the psychopathology of CD patients (submissive and hostile interpersonal styles) in contrast to non-CD patients. Results were inconsistent with regard to childhood maltreatment. No differences were found regarding the severity of depressive symptoms and most sociodemographic factors. Conclusion:Despite some inconsistencies, the results of this review verified important differences between CD and non-CD. However, future research is needed to characterize especially the specific psychopathology of CD in comparison to non-CD patients to develop more tailored treatment strategies. K E Y W O R D Sassessment/diagnosis, clinical trials, depression, dysthymic disorder, mood disorders 18

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Differences between chronic and nonchronic depression: Systematic review and implications for treatment

et al. 2018

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“…The group of patients with chronic, early-onset depression was reported to have specific features that distinguished it from other forms of depression [55]. Klein and Kotov [56] confirmed that this group is characterized by more early childhood adversity, more personality disorders, more comorbidity with other mental disorders, and more frequent suicide attempts.…”

Section: Discussionmentioning

confidence: 99%

Comparing the Efficacy of CBASP with Two Versions of CBT for Depression in a Routine Care Center: A Randomized Clinical Trial

Rief¹,

Bleichhardt²,

Dannehl³

et al. 2018

Psychother Psychosom

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Background: The cognitive-behavioral analysis system of psychotherapy (CBASP) was developed for the treatment of chronic, early-onset depression. However, it is unclear whether this approach can be recommended for depression in general (episodic and chronic), and no direct comparisons between CBASP with different versions of cognitive-behavioral therapy (CBT) exist. Methods: A randomized controlled trial compared 3 treatment conditions (all lasting 16 sessions) with a waiting list group (WL): CBASP, CBT with a focus on physical exercise (CBT-E), and CBT with a focus on pleasurable, low-energy and mindful activities (CBT-M). We included 173 patients and involved 41 therapists. Assessments were at baseline, after session 8, and at the end of treatment. Results: Our primary outcome Beck Depression Inventory-II indicated a general advantage of the CBT arms compared to CBASP [F(6, 154.5) = 4.2, p = 0.001], with significant contrasts in particular in favor of CBT-E. Effect sizes against WL were d = 0.91 (CBT-E), 0.87 (CBT-M), and 0.47 (CBASP). A triple interaction with an additional factor “chronic versus episodic depression” [F(6, 142.7) = 2.2, p = 0.048] indicated that the treatments resulted in different outcomes, with best results again for CBT-E in particular in episodic depression. Responder rates indicated significant improvements (56% in both CBT arms, 34% in the CBASP arm, 3.4% in WL; intention-to-treat samples). As compared to CBASP, response rates were significantly higher for CBT-E (OR = 2.48; 95% CI = 1.02–6.00) and CBT-M (OR = 2.46; 95% CI = 1.01–6.01). Conclusions: CBASP was more effective than WL, but less effective than the 2 CBT arms. This was mainly caused by an advantage of CBT interventions in episodic depression.

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“…Personality characteristics include smoking (82,94,111), alcohol consumption and drug use (77,91,94), relationship quality (91, 112, 113) (partner) violence experience (96,112,(114)(115)(116), threatening life events in the past 12 months (79,80,91,(117)(118)(119)(120), physical activity and sedentary behavior (94,106,111,(121)(122)(123), stress (15,43,79,124,125), need for affect, emotional avoidance (126)(127)(128), anxiety sensitivity (129-131), sense of mastery, internal locus of control (79,(132)(133)(134)(135), worry (136)(137)(138), self-worth (100,104,(139)(140)(141), and loneliness (142)…”

Section: Other Assessmentsmentioning

confidence: 99%

Clinical and Cost-Effectiveness of Personalized Tele-Based Coaching for Farmers, Foresters and Gardeners to Prevent Depression: Study Protocol of an 18-Month Follow-Up Pragmatic Randomized Controlled Trial (TEC-A)

et al. 2020

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Background: Farmers show high levels of depressive symptoms and mental health problems in various studies. This study is part of a nationwide prevention project carried out by a German social insurance company for farmers, foresters, and gardeners (SVLFG) to implement internet-and tele-based services among others to improve mental health in this population. The aim of the present study is to evaluate the (cost-)effectiveness of personalized tele-based coaching for reducing depressive symptom severity and preventing the onset of clinical depression, compared to enhanced treatment as usual.Methods: In a two-armed, pragmatic randomized controlled trial (N = 312) with follow-ups at post-treatment (6 months), 12 and 18 months, insured farmers, foresters, and gardeners, collaborating family members and pensioners with elevated depressive symptoms (PHQ-9 ≥ 5) will be randomly allocated to personalized tele-based coaching or enhanced treatment as usual. The coaching is provided by psychologists and consists of up to 34 tele-based sessions for 25-50 min delivered over 6 months. Primary outcome is depressive symptom severity at post-treatment. Secondary outcomes include depression onset, anxiety, stress, and quality of life. A health-economic evaluation will be conducted from a societal perspective.Discussion: This study is the first pragmatic randomized controlled trial evaluating the (cost-)effectiveness of a nationwide tele-based preventive service for farmers. If proven effective, the implementation of personalized tele-based coaching has the potential to reduce disease burden and health care costs both at an individual and societal level.

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Differentiating early-onset chronic depression from episodic depression in terms of cognitive-behavioral and emotional avoidance

Cited by 34 publications

References 48 publications

Differences between chronic and nonchronic depression: Systematic review and implications for treatment

Differences between chronic and nonchronic depression: Systematic review and implications for treatment

Comparing the Efficacy of CBASP with Two Versions of CBT for Depression in a Routine Care Center: A Randomized Clinical Trial

Clinical and Cost-Effectiveness of Personalized Tele-Based Coaching for Farmers, Foresters and Gardeners to Prevent Depression: Study Protocol of an 18-Month Follow-Up Pragmatic Randomized Controlled Trial (TEC-A)

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