Long-term effects of a cognitive-behavioral training program for the management of depressive symptoms among patients in orthopedic inpatient rehabilitation of chronic low back pain: a 2-year follow-up

Abstract

The aim of the present study was to investigate the 2-year outcome of a cognitive-behavioral training program for the management of depressive symptoms for patients with chronic low back pain (CLBP) and co-existing depressive symptoms compared with the standard rehabilitation. Therefore, a quasi-experimental 3 9 2 9 5 (treatment condition 9 gender 9 time) repeated measures design with five assessment points (pre-treatment, posttreatment, 6-, 12-, and 24-month follow-up) was employed among N = 153 patients with CLBP, aged 33-62 years. Patients were consecutively assigned to one of three treatment conditions: patients with no or mild depressive symptoms were treated with the standard rehabilitation (CG) and patients with moderate or severe depressive symptoms were either treated with the standard rehabilitation (CG depr ) or the standard rehabilitation plus cognitive-behavioral management of depressive symptoms (IG depr ). Patients in the IG depr significantly improved in mental health up to the 6-month follow-up and in anxiety and depressive symptoms up to the 24-month follow-up. Only short-or mid-term improvements were found in the CG depr . In conclusion, the new cognitive-behavioral training program augmented the long-term rehabilitation success in this highly strained subgroup of patients with CLBP and depressive symptoms.

Cognitive-behavioral management training of depressive symptoms among inpatient orthopedic patients with chronic low back pain and depressive symptoms: A 2-year longitudinal study

“…These results lend support to the assumption that both the rehabilitation success and the persistency of the rehabilitation effects among patients with CLBP and depressive symptoms may be enhanced by the implementation of a cognitive-behavioral treatment specifically targeting depressive symptoms. Supporting this assumption, former analysis showed that incorporating a cognitive-behavioral management of depressive symptoms into a multimodal and multidisciplinary standard rehabilitation augmented the rehabilitation effects on depressive symptoms and anxiety up to the 12-and 24-month follow-up assessment [23,24]. Additionally, the intervention group also showed reduced days of sick leave 6 months after rehabilitation compared to pre-treatment [23].…”

“…Additionally, the intervention group also showed reduced days of sick leave 6 months after rehabilitation compared to pre-treatment [23]. In contrast, the control group only benefited in anxiety 12 months after rehabilitation [23,24]. Between-group comparisons indicated that the intervention group had decreased levels of depressive symptoms and anxiety in comparison with the control group at the 6-month follow-up assessment [23,24].…”

“…In contrast, the control group only benefited in anxiety 12 months after rehabilitation [23,24]. Between-group comparisons indicated that the intervention group had decreased levels of depressive symptoms and anxiety in comparison with the control group at the 6-month follow-up assessment [23,24]. Moreover, between-group effects in depressive symptoms persisted up to 12 and 24 months after rehabilitation performing intention-to treat (ITT) analyses [24].…”

Langfristige Effekte einer kognitiv-behavioralen Intervention auf die Schmerzverarbeitung in der stationären orthopädischen Rehabilitation von chronisch unspezifischem Rückenschmerz und Depressivität

“…Anzumerken ist, dass sich die schmerzbedingte psychische Beeinträchtigung insgesamt in der vorliegenden Studie nicht veränderte, was konform mit Befunden unserer ersten Studie ist[ 28 ] . Dies steht im Gegensatz zu signifi kanten Zeiteff ekten in der Depressivität und der Angst der HADS von Tlach und Hampel[ 34 ] , die eine Verbesserung der psychischen Symptomatik untermauern. Somit stellen unsere Befunde die Änderungssensiti-vität dieser Dimension des FESV infrage, obwohl die Änderungs-sensitivität in den Validierungsstudien belegt werden konnte.Hinsichtlich der Schmerzverarbeitung konnte kein Interaktionseff ekt festgestellt werden.…”

Patienten mit chronisch unspezifischem Rückenschmerz: Zur Bedeutung psychosozialer Merkmale

“…: * kovarianzanalytische Ergebnisse mit der Ausgangslage als Kovariate, t Heruntergeladen von: University of Florida. Urheberrechtlich geschützt.den hoch chronifi zierten Patienten konnte nachgewiesen werden, dass die Interventionsgruppe sowohl in der Depressivit ä t als auch in der Angst langfristig positive Eff ekte aufwies, w ä hrend die Kontrollgruppe keine langfristige Verbesserung zeigte[41] . zierungsgrad Ü bereinstimmend mit fr ü heren Befunden zu einer intensivierten multidisziplin ä ren Rehabilitation chronischer R ü ckenschmerzen von Buchner et al[11] deuten auch unsere Ergebnisse darauf hin, dass sowohl die Patienten mit niedrigem als auch mit mittlerem Chronifi zierungsgrad in der Angst profitierten.…”