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What Predicts Outcome, Response, and Drop-out in CBT of Depressive Adults? A Naturalistic Study

Published online by Cambridge University Press:  05 December 2012

Amrei Schindler ,
Wolfgang Hiller  and
Michael Witthöft
Amrei Schindler*
Affiliation:
University of Mainz, Germany
Wolfgang Hiller
Affiliation:
University of Mainz, Germany
Michael Witthöft
Affiliation:
University of Mainz, Germany
*
Reprint requests to Amrei Schindler, Department of Psychology, University of Mainz, Wallstraße 3, 55122 Mainz, Germany. E-mail address: [email protected]
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Abstract

Background: The efficacy of CBT for unipolar depressive disorders is well established, yet not all patients improve or tolerate treatment. Aims: To identify factors associated with symptomatic outcome, response, and drop-out in depressive patients under naturalistic CBT. Method: 193 patients with major depression or dysthymia were tested. Sociodemographic and clinical variables were entered as predictors in hierarchical regression analyses. Results: A higher degree of pretreatment depression, early improvement, and completion of therapy were identified as predictors for symptomatic change and response. Drop-out was predicted by concurrent personality disorder, less positive outcome expectancies, and by failure to improve early in treatment. Conclusions: Our results highlight the importance of early response to predict improvement in routine CBT. Attempts to refine the quality of treatment programs should focus on avoiding premature termination (drop-out) and consider motivational factors in more depth. Routinely administered standardized assessments would enhance symptom monitoring and help to identify persons at risk of not improving under therapy.

Keywords

CBT for depressionnaturalistic designsymptomatic outcomeresponsedrop-out
Type
Brief Clinical Reports
Information
Behavioural and Cognitive Psychotherapy , Volume 41 , Issue 3 , May 2013 , pp. 365 - 370
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

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References

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