Effectiveness of Cognitive Behavior Therapy for Severe Mood Disorders in an Acute Psychiatric Naturalistic Setting: A Benchmarking Study

Abstract

The current study examined the effectiveness of brief cognitive behavior therapy (CBT) for severe mood disorders in an acute naturalistic setting. The sample included 951 individuals with either major depressive disorder (n = 857) or bipolar disorder with depressed mood (n = 94). Participants completed a battery of self-report measures assessing depression, overall well-being, and a range of secondary outcomes both before and after treatment. We found significant reductions in depressive symptoms, worry, self-harm, emotional lability, and substance abuse, as well as significant improvements in well-being and interpersonal relationships, post-treatment. Comparable to outpatient studies, 30% of the sample evidenced recovery from depression. Comparison of findings to benchmark studies indicated that, although the current sample started treatment with severe depressive symptoms and were in treatment for average of only 10 days, the overall magnitude of symptom improvement was similar to that of randomized controlled trials. Limitations of the study include a lack of control group, a limitation of most naturalistic studies. These findings indicate that interventions developed in controlled research settings on the efficacy of CBT can be transported to naturalistic, "real world" settings, and that brief CBT delivered in a partial hospital program is effective for many patients with severe depressive symptoms.

Network analysis of depression and anxiety symptom relationships in a psychiatric sample

“…Targeting the depression symptoms of sad mood, low energy, and anhedonia may therefore be most influential in reducing overall symptom severity. Cognitive Behavioral Therapy targets most of these symptoms directly via behavioral activation and cognitive restructuring, which may explain the ability of very brief CBT to improve depression symptoms (e.g., Björgvinsson, Kertz, Bigda-Peyton, Rosmarin, Aderka, & Neuhaus, 2014). Regarding anxiety symptoms, our findings suggest that treatments that first target worry should be most effective.…”

Transdiagnostic mechanisms in depression and anxiety: The role of rumination and attentional control

“…The partial hospital provides brief, intensive group, and individual evidenced-based psychotherapy (e.g., Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT)) and pharmacological treatment to patients suffering from a wide range of psychiatric disorders (principally mood, anxiety, personality, and psychotic disorders; see Björgvinsson et al, 2014 for more detail regarding the treatment setting). Patients were either stepping down from an inpatient hospitalization or stepping up their level of care from the community.…”

Predictors of Depression Treatment Response in an Intensive CBT Partial Hospital

“…The partial hospital provides transdiagnostic treatment with a focus on depression, and the current study examined only those patients reporting clinically significant depressive symptoms upon admission to the partial program. A recent benchmarking study from this partial hospital revealed a similar magnitude of improvement in depressive symptoms compared with RCTs (Björgvinsson et al., ); however, predictors of response were not examined. Thus, we sought to extend Björgvinsson et al.…”