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One-year follow-up of a randomized trial with a dilemma-focused intervention for depression: Exploring an alternative to problem-oriented strategies

Cognitive behavioural therapy (CBT) is aimed to counteract cognitions and behaviours that are considered as dysfunctional. The aim of the study is to test whether the inclusion of a non-counteractive approach (dilemma-focused intervention, DFI) in combination with CBT group therapy will yield better...

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Published in:PloS one 2018-12, Vol.13 (12), p.e0208245-e0208245
Main Authors: Feixas, Guillem, Paz, Clara, García-Grau, Eugeni, Montesano, Adrián, Medina, Joan C, Bados, Arturo, Trujillo, Adriana, Ortíz, Eliana, Compañ, Victoria, Salla, Marta, Aguilera, Mari, Guasch, Víctor, Codina, Jordi, Winter, David A
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cited_by cdi_FETCH-LOGICAL-c734t-5c9378bdabbc50d2551b00ec3b33200e91c3efe38835d7c3f2e5349f0e492ca43
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creator Feixas, Guillem
Paz, Clara
García-Grau, Eugeni
Montesano, Adrián
Medina, Joan C
Bados, Arturo
Trujillo, Adriana
Ortíz, Eliana
Compañ, Victoria
Salla, Marta
Aguilera, Mari
Guasch, Víctor
Codina, Jordi
Winter, David A
description Cognitive behavioural therapy (CBT) is aimed to counteract cognitions and behaviours that are considered as dysfunctional. The aim of the study is to test whether the inclusion of a non-counteractive approach (dilemma-focused intervention, DFI) in combination with CBT group therapy will yield better short- and long-term outcomes than an intervention conducted entirely using CBT. A total of 128 patients with depression and at least one cognitive conflict, of six health community centres in Barcelona, participated from November of 2011 to December of 2014 in seven weekly group CBT sessions and were then randomly allocated to either DFI or CBT (eight individual sessions each) by an independent researcher. Depressive symptoms were assessed with the Beck Depression Inventory-II at baseline, at the end of therapy and three- and twelve-month follow-ups. Therapists did not participate in any of the assessments nor in the randomisation of patients and evaluators were masked to group assignment. Both intention to treat and complete case analyses were performed using linear mixed models with random effects. According to intention-to-treat analysis (F2, 179 = 0.69) and complete case analysis (F2, 146 = 0.88), both conditions similarly reduced the severity of symptoms across posttreatment assessments. For the 77 participants (CBTgroup +CBTindividual = 40; CBTgroup+DFIindividual = 37) that completed allocated treatment and one-year follow-up assessment, response and remission rates were relative higher for the DFI condition, however no significant differences were found between treatment conditions. The relapse rates were similar between treatment conditions (CBTgroup +CBTindividual = 7/20; CBTgroup+DFIindividual = 8/22). Although using a counteractive approach across all the treatment sessions is quite effective, it does not seem to be necessary to produce significant improvement. DFI may be considered as an alternative, which could be included in a wider treatment for depression. ClinicalTrials.gov; ID: NCT01542957.
doi_str_mv 10.1371/journal.pone.0208245
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Arturo</au><au>Trujillo, Adriana</au><au>Ortíz, Eliana</au><au>Compañ, Victoria</au><au>Salla, Marta</au><au>Aguilera, Mari</au><au>Guasch, Víctor</au><au>Codina, Jordi</au><au>Winter, David A</au><au>van Wouwe, Jacobus P.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>One-year follow-up of a randomized trial with a dilemma-focused intervention for depression: Exploring an alternative to problem-oriented strategies</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2018-12-13</date><risdate>2018</risdate><volume>13</volume><issue>12</issue><spage>e0208245</spage><epage>e0208245</epage><pages>e0208245-e0208245</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Cognitive behavioural therapy (CBT) is aimed to counteract cognitions and behaviours that are considered as dysfunctional. The aim of the study is to test whether the inclusion of a non-counteractive approach (dilemma-focused intervention, DFI) in combination with CBT group therapy will yield better short- and long-term outcomes than an intervention conducted entirely using CBT. A total of 128 patients with depression and at least one cognitive conflict, of six health community centres in Barcelona, participated from November of 2011 to December of 2014 in seven weekly group CBT sessions and were then randomly allocated to either DFI or CBT (eight individual sessions each) by an independent researcher. Depressive symptoms were assessed with the Beck Depression Inventory-II at baseline, at the end of therapy and three- and twelve-month follow-ups. Therapists did not participate in any of the assessments nor in the randomisation of patients and evaluators were masked to group assignment. Both intention to treat and complete case analyses were performed using linear mixed models with random effects. According to intention-to-treat analysis (F2, 179 = 0.69) and complete case analysis (F2, 146 = 0.88), both conditions similarly reduced the severity of symptoms across posttreatment assessments. For the 77 participants (CBTgroup +CBTindividual = 40; CBTgroup+DFIindividual = 37) that completed allocated treatment and one-year follow-up assessment, response and remission rates were relative higher for the DFI condition, however no significant differences were found between treatment conditions. The relapse rates were similar between treatment conditions (CBTgroup +CBTindividual = 7/20; CBTgroup+DFIindividual = 8/22). Although using a counteractive approach across all the treatment sessions is quite effective, it does not seem to be necessary to produce significant improvement. DFI may be considered as an alternative, which could be included in a wider treatment for depression. ClinicalTrials.gov; ID: NCT01542957.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>30543642</pmid><doi>10.1371/journal.pone.0208245</doi><tpages>e0208245</tpages><orcidid>https://orcid.org/0000-0002-0160-3327</orcidid><orcidid>https://orcid.org/0000-0003-1106-9567</orcidid><orcidid>https://orcid.org/0000-0003-2656-2688</orcidid><orcidid>https://orcid.org/0000-0003-0460-2925</orcidid><orcidid>https://orcid.org/0000-0001-9201-8694</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1932-6203
ispartof PloS one, 2018-12, Vol.13 (12), p.e0208245-e0208245
issn 1932-6203
1932-6203
language eng
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source Publicly Available Content Database; PubMed Central
subjects Adolescent
Adult
Aged
Analysis
Assessments
Behavior modification
Behavior therapy
Behavioral medicine
Biology and Life Sciences
Care and treatment
Clinical psychology
Clinical trials
Cognitive ability
Cognitive Behavioral Therapy - methods
Cognitive-behavioral therapy
Community centers
Community involvement
Community participation
Depresión mental
Depression (Mood disorder)
Depression - therapy
Depression, Mental
Depressió psíquica
Female
Follow-Up Studies
Group counseling
Health
Health services
Humans
Internet
Intervention
Male
Medical diagnosis
Medicine and Health Sciences
Mental depression
Mental disorders
Mental health
Middle Aged
Motivation
Neurosciences
Patients
Personal construct theory
Practice guidelines (Medicine)
Psychobiology
Psychotherapy
Randomization
Randomized Controlled Trials as Topic
Remission
Social Sciences
Therapy
Treatment Outcome
Young Adult
title One-year follow-up of a randomized trial with a dilemma-focused intervention for depression: Exploring an alternative to problem-oriented strategies
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