Measuring success in the treatment of depression: what is most important to patients?

Cuijpers, Pim

doi:10.1080/14737175.2020.1712807

Cited by 14 publications

(9 citation statements)

References 15 publications

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“…Therefore, measures of recovery should not only build on BPD symptom thresholds but also consider psychosocial functioning, that is, the ability of the individual to engage in meaningful and sustained vocational and interpersonal relationships (Ng et al, 2016). The inclusion of general measures of psychosocial functioning as well as the patient-reported quality of life along with BPD symptom assessment is vital to allow for a meaningful interpretation of treatment effects, probably more than mere symptom reduction (Cuijpers, 2020).…”

Section: Discussionmentioning

confidence: 99%

Clinical trials in personality disorders: Recommendations for study design and conduct.

Stoffers‐Winterling¹,

Kongerslev²,

Simonsen³

et al. 2023

Personality Disorders: Theory, Research, and Treatment

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Borderline personality disorder (BPD) is a highly studied condition. During the last 3 decades, the understanding of the disorder has substantially changed, based on thorough, accumulating research. At the same time, the interest in BPD is still not decreasing but continues to grow. This article aims to critically discuss research trends in clinical trials of personality disorders in general and BPD in particular, to highlight topics that deserve closer attention, and to give recommendations for the design and conduct of future psychotherapy or pharmacotherapy studies in the field.

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Section: Discussionmentioning

confidence: 99%

Clinical trials in personality disorders: Recommendations for study design and conduct.

Stoffers‐Winterling¹,

Kongerslev²,

Simonsen³

et al. 2023

Personality Disorders: Theory, Research, and Treatment

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“…Another explanation for the observed differences in changes in symptom severity measures and our measure of well‐being might be the nature and focus of treatment. Several studies indicate that patients define “good therapy outcome” as clustered around four themes: establishing new ways of relating to others; less symptomatic distress, or changes in behavioral patterns contributing to suffering; better self‐understanding and insight; and accepting and valuing oneself (Binder et al, 2010; Cuijpers, 2020). The applied treatments in our study (both pharmacotherapy and psychotherapy) are mainly symptom focused therapies, thus mainly leading to symptom reductions.…”

Section: Discussionmentioning

confidence: 99%

The relationship between depressive symptoms, general psychopathology, and well‐being in patients with major depressive disorder

et al. 2020

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Objective: In mental health care, treatment effects are commonly monitored by symptom severity measures. This study aimed to investigate the relationship between symptom severity and well-being in the treatment of patients with major depressive disorder (MDD). Methods: Adult MDD outpatients (n = 77) were administered the Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR), the Outcome Questionnaire (OQ-45), and the Mental Health Continuum-Short Form (MHC-SF) before treatment and 6 months later. Results: Symptom severity correlated moderately with well-being at baseline and strongly at follow-up. Reliable change index scores showed improvement on the QIDS-SR, OQ-45, and MHC-SF in 65%, 59%, and 40%, respectively. A quarter of patients improved in symptom severity but not well-being (Inventory of Depressive Symptomatology-Self-Report [IDS-SR]: 25%; OQ-45: 24%). Conclusion:Findings suggest that symptom severity and subjective well-being are related, but distinct concepts.Several reasons for the stronger improvements in symptoms than in well-being are discussed.

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“…Recovery is commonly recognised as a multidimensional concept (Zimmerman et al ., 2006; Cuijpers, 2020; Fava and Guidi, 2020). Going beyond the one-dimensional concept of recovery in its clinical aspect, in which intervention effectiveness is mostly defined by reductions in symptom severity with secondary measures, including hospitalisation outcomes and medication use (Turton et al ., 2010), a broader definition of recovery encompasses a focus on well-being, which is more in line with patients' perspectives on recovery.…”

Section: Introductionmentioning

confidence: 99%

Housing First for homeless people with severe mental illness: extended 4-year follow-up and analysis of recovery and housing stability from the randomized Un Chez Soi d'Abord trial

Loubière

Lemoine

Boyer

et al. 2022

Epidemiol Psychiatr Sci

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Aims Housing First (HF), a recovery-oriented approach, was proven effective in stabilising housing situations of homeless individuals with severe mental disorders, yet had limited effectiveness on recovery outcomes on a short-term basis compared to standard treatment. The objective was to assess the effects of the HF model among homeless people with high support needs for mental and physical health services on recovery, housing stability, quality of life, health care use, mental symptoms and addiction issues on 4 years of data from the Un Chez Soi d'Abord trial. Methods A multicentre randomised controlled trial was conducted from August 2011 to April 2018 with intent-to-treat analysis in four French cities: Lille, Marseille, Paris and Toulouse. Participants were homeless or precariously-housed patients with a DSM-IV-TR diagnosis of bipolar disorder or schizophrenia. Two groups were compared: the HF group (n = 353) had immediate access to independent housing and support from the assertive community treatment team; the Treatment-As-Usual (TAU) group (n = 350) had access to existing support and services. Main outcomes were personal recovery (Recovery Assessment Scale (RAS) scale), housing stability, quality of life (S-QoL), global physical and mental status (Medical Outcomes Study 36-item Short Form Health Survey (SF-36)), inpatient days, mental symptoms (Modified Colorado Symptom Index (MCSI)) and addictions (Mini International Neuropsychiatric Interview (MINI) and Alcohol Use Disorders Identification Test (AUDIT)). Mixed models using longitudinal and cluster designs were performed and adjusted to first age on the street, gender and mental disorder diagnosis. Models were tested for time × group and site × time interactions. Results The 703 participants [123 (18%) female] had a mean age of 39 years (95% CI 38.0–39.5 years). Both groups improved RAS index from baseline to 48 months, with no statistically significant changes found between the HF and TAU groups over time. HF patients exhibited better autonomy (adjusted β = 2.6, 95% CI 1.2–4.1) and sentimental life (2.3, 95% CI 0.5–4.1), higher housing stability (28.6, 95% CI 25.1–32.1), lower inpatient days (−3.14, 95% CI −5.2 to −1.1) and improved SF-36 mental composite score (−0.8, 95% CI −1.6 to −0.1) over the 4-year follow-up. HF participants experienced higher alcohol consumption between baseline and 48 months. No significant differences were observed for self-reported mental symptoms or substance dependence. Conclusion Data at 4 years were consistent with 2-year follow-up data: similar improvement in personal recovery outcomes but higher housing stability, autonomy and lower use of hospital services in the HF group compared to the TAU group, with the exception of an ongoing alcohol issue. These sustained benefits support HF as a valuable intervention for the homeless patients with severe mental illness. Trial registration ClinicalTrials.gov identifier: NCT01570712

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Measuring success in the treatment of depression: what is most important to patients?

Cited by 14 publications

References 15 publications

Clinical trials in personality disorders: Recommendations for study design and conduct.

Clinical trials in personality disorders: Recommendations for study design and conduct.

The relationship between depressive symptoms, general psychopathology, and well‐being in patients with major depressive disorder

Housing First for homeless people with severe mental illness: extended 4-year follow-up and analysis of recovery and housing stability from the randomized Un Chez Soi d'Abord trial

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