The treatment of chronic depression with cognitive behavioral analysis system of psychotherapy: a systematic review and meta‐analysis of randomized‐controlled clinical trials

Negt, Philip; Brakemeier, Eva‐Lotta; Michalak, Johannes; Winter, Lotta; Bleich, Stefan; Kahl, Kai G.

doi:10.1002/brb3.486

Cited by 93 publications

(65 citation statements)

References 85 publications

(108 reference statements)

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“…Systematic reviews and meta-analyses of the evidence for the efficacy of third-wave treatments in improving a range of mental health outcomes have yielded support for ACT (A-Tjak et al, 2015;Bluett, Homan, Morrison, Levin, & Twohig, 2014;Hacker, Stone, & MacBeth, 2016;Lee, An, Levin, & Twohig, 2015), DBT (Kliem, Kröger, & Kosfelder, 2010;Panos, Jackson, Hasan, & Panos, 2014), MCT (Normann, van Emmerik, & Morina, 2014), MBCT (Chiesa & Serretti, 2011;Piet & Hougaard, 2011), schema therapy (Jacob & Arntz, 2013), CBASP (Negt et al, 2016), CFT, and CMT (Leaviss & Uttley, 2015). These prior reviews examined outcomes including personality disorders, substancerelated disorders, anxiety disorders, and mood disorders, such as major depressive disorder and chronic depression, as well as process measures and satisfaction with life.…”

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confidence: 99%

The Efficacy and Acceptability of Third-Wave Behavioral and Cognitive eHealth Treatments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2018

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eHealth is an innovative method of delivering therapeutic content with the potential to improve access to third-wave behaviural and cognitive therapies. This systematic review and meta-analysis aimed to determine the efficacy and acceptability of third-wave eHealth treatments in improving mental health outcomes. A comprehensive search of electronic bibliographic databases including PubMed, PsycINFO, Web of Science, and CENTRAL was conducted to identify randomized controlled trials of third-wave treatments in which eHealth was the main component. Twenty-one studies were included in the review. Meta-analyses revealed that thirdwave eHealth significantly outperformed inactive control conditions in improving anxiety, depression, and quality-oflife outcomes and active control conditions in alleviating anxiety and depression with small to medium effect sizes. No statistically significant differences were found relative to comparison interventions. Findings from a narrative synthesis of participant evaluation outcomes and meta-analysis of participant attrition rates provided preliminary support for the acceptability of third-wave eHealth.Third-wave eHealth treatments are efficacious in improving mental health outcomes including anxiety, depression, and quality of life, but not more so than comparison interventions. Preliminary evidence from indices of participant evaluation and attrition rates supports the acceptability of these treatments.

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confidence: 99%

The Efficacy and Acceptability of Third-Wave Behavioral and Cognitive eHealth Treatments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

et al. 2018

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“…One of the most promising approaches based on posttreatment outcome [8] is the only disorder-specific psychotherapy for chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) [9], although not all findings investigating it have been fully supportive [10, 11]. The evidence for the long-term effectiveness of CBASP is limited.…”

Section: Introductionmentioning

confidence: 99%

Two-Year Follow-Up after Treatment with the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for Early-Onset Chronic Depression

Schramm

Kriston

Elsaeßer

et al. 2019

Psychother Psychosom

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Background: Evidence on the long-term efficacy of psychotherapeutic approaches for chronic depression is scarce. Objective: To evaluate the effects of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) compared to Supportive Psychotherapy (SP) 1 year and 2 years after treatment termination. Methods: In this study, we present 1- and 2-year follow-up assessments of a prospective, multicenter, evaluator-blinded, randomized clinical trial of outpatients with early-onset chronic major depression (n = 268). The initial treatment included 32 sessions of CBASP or SP over 48 weeks. The primary outcome was the rate of “well weeks” (Longitudinal Interval Follow-Up Evaluation; no/minimal symptoms) after 1 year and 2 years. The secondary outcomes were, among others, clinician- and self-rated depressive symptoms, response/remission rates, and quality of life. Results: Of the 268 randomized patients, 207 (77%) participated in the follow-up. In the intention-to-treat analysis, there was no statistically significant difference between CBASP and SP patients in experiencing well weeks (CBASP: mean [SD] of 48.6 [36.9] weeks; SP: 39.0 [34.8]; rate ratio 1.26, 95% CI 0.99–1.59, p = 0.057, d = 0.18) and in remission rates (CBASP: 1 year 40%, 2 years 40.2%; SP: 1 year 28.9%, 2 years 33%) in the 2 years after treatment. Statistically significant effects were found in favor of CBASP 1 year after treatment termination regarding the rate of well weeks, self-rated depressive symptoms, and depression-related quality of life. Conclusions: CBASP lost its superiority over SP at some point between the first and the second year. This suggests the necessity of maintenance treatment for early-onset chronically depressed patients remitted with CBASP during the acute therapy phase, as well as the sequential integration of other treatment strategies, including medication for those who did not reach remission.

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“…Preliminary meta-analyses about CBASP confirm its efficacy [48], although the average effect size compared to treatment as usual was small (g = 0.34–0.44), and similar to drug treatments in chronic depression [39]. Inpatient adaptations report large effect sizes in uncontrolled one-arm designs, again in chronic depression [49], but uncontrolled factors could have also contributed to these large effect sizes.…”

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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The treatment of chronic depression with cognitive behavioral analysis system of psychotherapy: a systematic review and meta‐analysis of randomized‐controlled clinical trials

Cited by 93 publications

References 85 publications

The Efficacy and Acceptability of Third-Wave Behavioral and Cognitive eHealth Treatments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

The Efficacy and Acceptability of Third-Wave Behavioral and Cognitive eHealth Treatments: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Two-Year Follow-Up after Treatment with the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for Early-Onset Chronic Depression

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

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