Dynamic interpersonal therapy for moderate to severe depression: a pilot randomized controlled and feasibility trial
| Autor: | Peter Fonagy, John Cape, Elizabeth Allison, Alessandra Lemma, Anthony D. Roth, Mary Target, Stephen Pilling, Sally O'Keeffe, Patrick Luyten, Tamara Ventura Wurman, Matthew P. Constantinou |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Psychology Clinical Social Sciences INVENTORY Pilot Projects dynamic interpersonal therapy law.invention IAPT 0302 clinical medicine Randomized controlled trial law Surveys and Questionnaires Psychology Medicine Applied Psychology Depression (differential diagnoses) Psychiatry Psychodynamic psychotherapy Depression Middle Aged mentalization-based Psychiatry and Mental health Treatment Outcome England Improving Access to Psychological Therapies Major depressive disorder Female HEALTH Psychotherapy Psychodynamic Life Sciences & Biomedicine Adult Moderate to severe medicine.medical_specialty DISORDERS BF Interpersonal communication SELF-REPORT Young Adult 03 medical and health sciences PSYCHOTHERAPY Adults Humans METAANALYSIS Psychiatric Status Rating Scales Depressive Disorder Major Science & Technology DIT Cognitive Behavioral Therapy Primary Health Care business.industry Hamilton Rating Scale for Depression medicine.disease 030227 psychiatry psychodynamic randomized controlled trial Physical therapy Feasibility Studies major depression business 030217 neurology & neurosurgery time-limited treatment |
| Zdroj: | Psychological Medicine. 50:1010-1019 |
| ISSN: | 1469-8978 0033-2917 |
| Popis: | BackgroundImproving Access to Psychological Therapies (IAPT) services treat most patients in England who present to primary care with major depression. Psychodynamic psychotherapy is one of the psychotherapies offered. Dynamic Interpersonal Therapy (DIT) is a psychodynamic and mentalization-based treatment for depression. 16 sessions are delivered over approximately 5 months. Neither DIT's effectiveness relative to low-intensity treatment (LIT), nor the feasibility of randomizing patients to psychodynamic or cognitive-behavioural treatments (CBT) in an IAPT setting has been demonstrated.Methods147 patients were randomized in a 3:2:1 ratio to DIT (n = 73), LIT (control intervention; n = 54) or CBT (n = 20) in four IAPT treatment services in a combined superiority and feasibility design. Patients meeting criteria for major depressive disorder were assessed at baseline, mid-treatment (3 months) and post-treatment (6 months) using the Hamilton Rating Scale for Depression (HRSD-17), Beck Depression Inventory-II (BDI-II) and other self-rated questionnaire measures. Patients receiving DIT were also followed up 6 months post-completion.ResultsThe DIT arm showed significantly lower HRSD-17 scores at the 6-month primary end-point compared with LIT (d = 0.70). Significantly more DIT patients (51%) showed clinically significant change on the HRSD-17 compared with LIT (9%). The DIT and CBT arms showed equivalence on most outcomes. Results were similar with the BDI-II. DIT showed benefit across a range of secondary outcomes.ConclusionsDIT delivered in a primary care setting is superior to LIT and can be appropriately compared with CBT in future RCTs. |
| Databáze: | OpenAIRE |
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