“Coping with depression”: an open study of the efficacy of a group psychoeducational intervention in chronic, treatment-refractory depression (original) (raw)
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Journal of Affective Disorders, 2007
Background: People with subclinical depressive symptoms are at increased risk of depressive disorder, little is known on the prevention of depressive disorder in this population. This study evaluates the long-term preventive effects of an effective depression treatment, the Coping with Depression (CWD) course. This paper describes the effect of the CWD course on the incidence of depressive episodes and depressive symptoms, and explores whether the initial level of symptoms and gender has differential intervention effects. Methods: Participants (N = 104) were adults with subclinical depressive symptoms, who were randomly assigned to either a preventive group course condition, the 'Coping with Depression' course, or to an assessment-and-advice-only control group condition. Follow-up results were measured 6 and 12 months after completion of the course. Results: The CWD course showed to be effective in preventing depressive symptomatology but there was no evidence that the course prevented depressive disorder. 25% of the control group and 27.3% of the course group developed a depressive disorder within a year. Initial depressive symptomatology moderated the outcomes: only participants with low initial symptomatology appeared to benefit in the long term from course participation. Conclusions: The CWD course is effective as a treatment for subclinical depression. Preventive effects are restricted to participants with initially low depression levels. Therefore, this subgroup should be targeted in future depression-prevention practices and in future prevention studies.
Psychoeducational treatment and prevention of depression: The
Clinical Psychology …, 2009
This meta-analysis found that the Coping with Depression course was effective for preventing new cases of major depressive disorders in people without a disorder at baseline and was also effective for treating existing depression. These conclusions were supported by the analysis results, but their reliability is unclear due to the lack of reporting of the review methods. Authors' objectives To review the effectiveness of the Coping with Depression course. Searching Studies were identified in the following ways: from those conducted by the review authors and their colleagues; from a database of studies on the psychological treatment of depression, which was developed from a comprehensive literature search for articles from 1966 to December 2007 in PsycINFO, PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), and DAI; and from those identified in earlier meta-analyses. The search terms were partially reported and the reference lists of identified articles were searched. Study selection Randomised controlled trials of the Coping with Depression course used for the prevention or treatment of depression were eligible for inclusion if they compared the intervention with a control or another treatment for adult depression, which could be psychotherapy or pharmacotherapy. In trials of prevention, Coping with Depression was used for participants with subthreshold depression (symptoms that did not meet the criteria for a depressive disorder) that was established by a diagnostic interview. The control groups received care as usual and the outcome was the incidence of new depressive disorders. In treatment trials, most of the participants met the criteria for a depressive disorder, based on a diagnostic interview, while the other participants were classified using a self-rated depression score. The outcome was the reduction in depressive symptoms. Interventions were delivered to groups, individuals, or both and were compared with care as usual, waiting list, relaxation, or life skills. The participants in prevention and treatment trials were adolescents, adults, minority adults, older adults (aged over 50 years), alcoholics, or women with post-natal depression. Where reported, the number of sessions ranged from five to 16, with sessions lasting from five minutes to two hours. For prevention trials, the incidence rate ratio was calculated by the incidence rate of new depressive disorders with Coping with Depression, relative to the control group, divided by the number of person-years at risk (to account for different lengths of follow-up across trials). For treatment trials, the means and standard deviations for post-test outcomes were extracted for Coping with Depression and control groups and these were used to calculate Cohen's d effect sizes. If a study reported more than one depression measure, the mean of all effect sizes was calculated. The authors did not state how many reviewers extracted the data.
Clinical Psychology Review, 2009
The "Coping with Depression" course (CWD) is by the far the best studied psychoeducational intervention for the treatment and prevention of depression, and is used in routine practice in several countries. The CWD is a highly structured cognitive-behavioral intervention, which has been adapted for several goals, contexts, and target populations. The efficacy of the CWD has been examined in 25 randomized controlled trials. We conducted a meta-analysis of these studies. The 6 studies aimed at the prevention of new cases of major depression were found to result in a reduced risk of getting major depression of 38% (incidence rate ratio was 0.62). The 18 studies examining the CWD as a treatment of depression found a mean effect size (Cohen's d) of 0.28. Direct comparisons with other psychotherapies did not result in any indication that the CWD was less efficacious. The CWD is a flexible treatment which can easily be adapted for different populations and this may have led researchers to use this intervention for complex target groups, which in turn may have resulted in a lower mean effect size. The CWD has contributed considerably to the development and innovation of prevention and treatment of depression in many target populations.
The efficacy of psychoeducation on recurrent depression: a randomized trial with a 2-year follow-up
Nordic journal of psychiatry, 2017
The efficacy of psychoeducation is well documented in the treatment of relapse prevention of schizophrenia, and recently also in bipolar disorder; however, for recurrent depression only few controlled studies focusing on the efficacy of psychoeducation have been conducted. This randomized study tests the efficacy of treatment-as-usual supplemented with a psychoeducative programme for patients with recurrent depression, treated at Community Mental Health Centres (CMHC) in Denmark. The primary outcome measurements concern was decline in consumption of psychiatric inpatient services and decline in Beck's Depression Inventory (BDI). Eighty patients were randomized, either to the psychoeducative programme (consisting of eight sessions, each of 2 hours duration) and 2-year outpatient follow-up (42 cases), or only to 2-year outpatient follow-up (38 controls). The patients were monitored during 2 years after randomization. Data were collected from interviews including BDI, drug treatmen...
Behavior Therapy, 2003
This article reports on a randomized controlled trial investigating the short-term effectiveness of the Coping With Depression course in a sample of adults seriously at risk of developing major depression. In addition, possible mediating properties of several proximal outcome variables were assessed. Participants (N = 110) were adults with subclinical depressive symptoms. They were randomly assigned to either a group course condition, the Coping With Depression course, or an assessmentand-advice-only control group condition. Short-term results measured 1 month after completion of the course reveal that the course is effective in reducing depressive symptoms. The group course condition showed beneficial effects on depressive symptoms, pleasant activities, self-esteem, social skills, social support, and depressive thoughts. Changes in depressive cognition and self-esteem proved to be significant mediators of depressive symptoms. Possible implications for depression prevention are discussed.
Staying well after depression: trial design and protocol
BMC …, 2010
Background: Depression is often a chronic relapsing condition, with relapse rates of 50-80% in those who have been depressed before. This is particularly problematic for those who become suicidal when depressed since habitual recurrence of suicidal thoughts increases likelihood of further acute suicidal episodes. Therefore the question how to prevent relapse is of particular urgency in this group.