A Randomized Trial of Interpersonal Psychotherapy and Cognitive Behavioral Therapy for Major Depressive Disorder: Predictors of process and outcome
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]
Interpersonal Psychotherapy (IPT) and Cognitive Behavioral Therapy (CBT) are both evidence-based treatments for Major Depressive Disorder (MDD). Several head-to-head comparisons between these methods have been made, most of them in the US. There is a need for more trials in different treatment settings. This thesis is based on a randomized controlled trial of CBT and IPT for MDD in a community-based psychiatric outpatient clinic. In the trial, treatment outcome and mentalization change was compared between the methods. In addition, the significance of pre-treatment mentalization for subsequent alliance and outcome was analyzed. Ninety-six patients, about half of them with personality disorders, were randomized to 14 sessions of CBT or IPT. The hypothesis was that IPT would not be inferior to CBT which was confirmed. CBT had a significantly higher drop-out rate. Initial capacity for mentalization predicted alliance and outcome in both IPT and CBT. The level of mentalization was changed in IPT but not in CBT
Abstract [sv]
Interpersonell Psykoterapi (IPT) och Kognitiv Beteendeterapi (KBT) är båda evidensbaserade psykoterapier för egentlig depression. Flera direkta jämförelser mellan dessa terapimetoder har gjorts, de flesta i USA. Det finns dock ett behov av fler studier i olika socio-kulturella kontexter och behandlingsmiljöer. Denna avhandling är baserad på en randomiserad kontrollerad studie av KBT och IPT för egentlig depression på en psykiatrisk öppenvårdsmottagning. Behandlingsutfall och förändring i mentaliseringsförmåga jämfördes mellan metoderna. Dessutom studerades betydelsen av mentaliseringsförmågan före behandlingen som prediktor för allians och utfall. Nittiosex patienter, varav ca hälften med personlighetsstörning, randomiserades till 14 sessioner med IPT eller KBT. Hypotesen var att IPT inte skulle ha sämre utfall än KBT, vilket bekräftades. KBT hade signifikant högre grad av terapiavbrott. Initial mentaliseringsförmåga predicerade allians och utfall, både i IPT och KBT. Mentaliseringsförmågan ökade i IPT men inte i KBT.
Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 2016. , p. 92
Series
Linköping Studies in Arts and Science, ISSN 0282-9800 ; 675Linköping Studies in Behavioural Science, ISSN 1654-2029 ; 196
Keywords [en]
Clinical trail, Interpersonal psychotherapy, Cognitive behavioral therapy, major depressive disorder, drop-outs, mentalization, reflective functioning, working alliance
Keywords [sv]
Randomiserad studie, egentlig depression, Interpersonell psykoterapi, kognitiv beteendeterapi, drop-out, utfall, mentaliseringsförmåga, arbetsallians
National Category
Psychiatry Applied Psychology
Identifiers
URN: urn:nbn:se:liu:diva-125993ISBN: 978-91-7685-803-5 (print)OAI: oai:DiVA.org:liu-125993DiVA, id: diva2:911081
Public defence
2016-04-15, I:101, Hus I, Campus Valla, Linköping, 13:00 (Swedish)
Supervisors
2016-03-112016-03-112016-03-11Bibliographically approved
List of papers