Effectiveness of Short‐Term Dynamic Group Psychotherapy in Primary Care for Patients with Depressive Symptoms

Abstract

An open prospective controlled study was designed to compare the efficacy of short‐term dynamic group psychotherapy with the standard treatment in patients with depressive symptoms attended in the primary care setting. A total of 115 patients with depressive symptoms were assigned to receive psychotherapy (75 min) over 9 months (37 to 39 sessions) (n = 70) or the standard care (n = 45). Outcome measures were the differences between baseline and post‐treatment in the 17‐item Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM‐A) and the Short‐Form Health Survey (SF‐12) questionnaire in the two study groups. At the end of dynamic group psychotherapy, statistically significant improvements in the mean scores of all questionnaires were observed, whereas in control patients, significant improvements were only observed in the HDRS‐17 scale and in the Mental Component Summary score of the SF‐12. The mean changes after treatment were also higher in the psychotherapy group than in controls in all outcome measures, with statistically significant differences in the mean differences in favour of the psychotherapy group. In summary, implementation of short‐term dynamic group psychotherapy run by experienced psychotherapists for patients with depressive symptoms attended in routine primary care centres is feasible and effective. © 2016 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.Key Practitioner Message Short‐term dynamic group psychotherapy was delivered as a non‐pharmacological intervention to improve depressive symptoms.Statistically significant differences as compared with a control group were observed in 17‐item Hamilton Depression Rating Scale (HDRS), Hamilton Anxiety Rating Scale (HAM‐A) and the Short‐Form Health Survey (SF‐12) questionnaire.Implementation of short‐term dynamic group psychotherapy run by experienced psychotherapists for patients with depressive symptoms attended in routine primary care centres is feasible and effective.

Psychological Treatment of Depression in Primary Care: Recent Developments

“…− It is not aimed at solutions or acquiring new skills.− The assumption is that relief from personal problems may be achieved through discussion with others.− Often described in the literature as either counseling or (non-directive) supportive therapy.− Counseling is examined in primary care in several studies.− No meta-analysis of trials of counseling in primary care has been conducted.− Meta-analyses of counseling across settings have included several dozens of trials, resulting in effects that may be somewhat smaller than other therapies, but this is not clear [19, 28]. Other types of therapyThere are many other types of therapy that have been tested in other settings, but not extensively in primary care:− Psychodynamic therapies are based on the psycho-analytic framework and try to help patients through resolve depression through enhancing the patient’s understanding, awareness, and insight about repetitive conflicts [29]. − Life review therapy is mainly used in older adults and is aimed at resolving conflicts from the past and make up the balance of one’s life [30, 31].…”

“…− Psychodynamic therapies are based on the psycho-analytic framework and try to help patients through resolve depression through enhancing the patient’s understanding, awareness, and insight about repetitive conflicts [29].…”

Propuesta de un modelo de registro médico integral para la evaluación de depresión y ansiedad en atención primaria en Colombia: estudio de grupos focales

“…Asimismo, los médicos tienen dificultad para evaluar los resultados del tratamiento y, por consiguiente, se obtienen bajas tasas de remisión. Además, por el subdiagnóstico debido a la falta de tiempo, la sobrecarga laboral y la poca destreza para hacer el diagnóstico de depresión, se limita la continuidad (13,16).…”

The use of narrative research for the learning of group dynamics by professionals from Psychosocial Care Centers

“…As for the therapeutic results of the group, it is noteworthy that, in the scenes narrated, as well as in the discussions that followed, priority was given to strategies for checking the group process and the relational patterns characterizing it. There is no evidence on the use of efficacy assessment to compare health conditions, quality of life, or remission of symptoms, as international studies (27) often report.…”