Childhood maltreatment as predictor and moderator for treatment outcome in patients with major depressive disorders treated with metacognitive therapy or behavioral activation.

Autor: Schaich A; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany; Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany. Electronic address: anja.schaich@uksh.de., Assmann N; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany; Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany., Jauch-Chara K; Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany., Alvarez-Fischer D; Institute of Neurogenetics, University of Lübeck, Lübeck, Germany; Institute of Systems Motor Science, University of Lübeck, Lübeck, Germany., Klein JP; Department of Psychiatry, Psychosomatics and Psychotherapy, University of Lübeck, Lübeck, Germany., Fassbinder E; Department of Psychiatry and Psychotherapy, Christian-Albrechts-Universität zu Kiel, Kiel, Germany.
Jazyk: angličtina
Zdroj: Journal of affective disorders [J Affect Disord] 2024 Dec 15; Vol. 367, pp. 238-243. Date of Electronic Publication: 2024 Sep 02.
DOI: 10.1016/j.jad.2024.09.002
Abstrakt: Background: Childhood maltreatment (CM) is a risk factor for developing and maintaining depression. It is unclear whether CM influences the effect of treatments for depression. This study examined CM's predictor and moderator effect in Behavioral Activation (BA) and Metacognitive Therapy (MCT).
Method: CM was analyzed in a trial comparing a six months treatment program of either BA or MCT for 122 outpatients with major depressive disorder (MDD). Depression was assessed by the Hamilton Rating Scale for Depression (HRSD-24). CM was assessed using the Childhood Trauma Questionnaire (CTQ).
Results: Linear mixed models showed no predictor or moderator effects for the CTQ total score (all p > .58) but revealed a moderator effect for 'sexual abuse' on the reduction of depressive symptoms (β = 10.98, SE = 4.48, p = .015) indicating that patients with experiences of childhood sexual abuse benefited more from BA. There also was a predictor effect for 'physical neglect' (β = -3.35, SE = 1.70, p = .049): patients without the experience of physical neglect benefited more from treatment regardless of condition. Exploratory analyses indicated no predictor or moderator effects for the onset or persistence of depression, comorbid anxiety disorders or Cluster-C PDs (all p > .28).
Limitations: Limitations include small sample sizes for some of the subsamples.
Conclusion: Childhood sexual abuse seems to moderate treatment effectiveness in a sample of severely affected outpatients with MDD treated with MCT or BA. If confirmed in further trials, a history of sexual abuse might guide the choice between MCT and BA.
Trial Registration: German Clinical Trials Register DRKS-ID: DRKS00011536 (retrospectively registered on February 13, 2017, without changes to the study protocol).
Competing Interests: Declaration of competing interest EF and JPK have provided training or published books on Depression, MCT, or BA. The remaining authors declare that the research was conducted without commercial or financial relationships construed as a potential conflict of interest.
(Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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