Introduction. Major depressive disorder (MDD) is a prevalent, debilitating and disabling disorder, and its prevalence is increasing. Antidepressants (AD), cognitive-behavioral therapy (CBT) and behavioral activation (BA) are the main treatments for MDD. Trial-based cognitive therapy (TBCT) addresses and restructures dysfunctional negative core beliefs (CBs) and is a novel and promising approach. Objective. The aim of this study was to compare the efficacy of TBCT, BA and treatment as usual (TAU) in the treatment of MDD. Methods. A total of 76 patients with MDD were randomized into 1 of 3 groups and evaluated at baseline, after 6 weeks and at week 12 (final evaluation). The primary outcome was changing in HAM-D scores, and the secondary outcomes included scores on the BDI, CD-Quest, Sheehan Disability Scale (SDS) and WHOQOL. Results. Both TBCT and BA (which also included AD) were different from TAU (which included antidepressants alone) in reducing the HAM-D and BDI scores and other measures. TBCT and BA were different from TAU in the reduction of disability in SDS and WHOQOL physical domain scores. Besides limited by a small sample size, the dropout rate in the TAU arm was higher, and only 10 patients completed the 3 evaluations. Conclusion. This trial provides evidence that TBCT and BA combined with antidepressants were more efficacious than the TAU (drug alone) in reducing the severity of depressive symptoms and disability, showing that this combination can be useful for clinical practice.

INTRODUCTION:Childhood maltreatment is extremely harmful to health, especially regarding the development of psychiatric disorders throughout life. The objective of this study was to describe the prevalence and types of maltreatment and investigate the association between maltreatment and anxiety and depressive symptoms, sociodemographic variables, and risk behaviors in a sample of school adolescents. The study also identified which variables were Trends Psychiatry Psychother -Pre-Proof -http://doi.org/10.47626/2237-6089-2021-0456 the greatest predictors of anxiety and depressive symptoms. METHOD: We conducted a crosssectional study with a sample of 654 students aged 11 to 17 years. We collected sociodemographic data and applied the Revised Child Anxiety and Depression Scale (RCADS-47) to measure anxiety and depressive symptoms, and the Childhood Trauma Questionnaire (CTQ) to evaluate maltreatment and adverse experiences in childhood and adolescence, like abuse and negligence. Statistical analyses were made to obtain correlations between sociodemographic data, anxiety, depression, and types of maltreatment. Also, a regression analysis was made to identify the maltreatment types that predict psychological symptoms. RESULTS:Emotional abuse and emotional neglect are the most prevalent types of maltreatment. Statistically, emotional abuse was the maltreatment most correlated with depression and anxiety and tended to co-occur simultaneously with other types of maltreatment. Also, emotional and sexual abuse were the greatest predictors of anxiety and depression in adolescence. Conclusion: The above results reinforce the findings of previous studies in terms of understanding the effects of maltreatment. They point to emotional abuse as the main predictor of depressive and anxiety symptoms.