The effect of cognition and age on the efficacy of psychotherapy in late-life depression.

Background: Cognitive impairment is prevalent in older age and in patients with depression, which may limit the efficacy of psychotherapy for late-life depression (LLD). We analyzed the effect of age and baseline cognition on the efficacy of psychotherapy in LLD.

Methods: This secondary analysis of a randomized controlled multicenter study included 213 participants (60-92 years) with moderate to severe depression who had received either supportive psychotherapy (SUI) or an LLD-specific cognitive behavioral therapy (LLD-CBT), both of which led to a substantial reduction in depressive symptoms.

Interpersonal vs. supportive group psychotherapy for depression attributed to work stress: study protocol of the multicentre, cluster-randomised, controlled IPT-Work trial.

Background: Depression associated with occupational stress is highly prevalent, causing high rates of sick leave and thus posing significant societal and economic burden. Meta-analyses of the few studies on psychological and work-focused interventions for common mental disorders including depression report small effects on depressive symptomatology and occupational outcomes. There is an urgent need for more controlled studies on work-directed interventions assessing work outcomes.

Efficacy of psychotherapy versus pharmacotherapy, or their combination, in chronic depression: study protocol for a systematic review and network meta-analysis using aggregated and individual patient data.

Introduction: Chronic depression represents a common and highly disabling disorder. Several randomised controlled trials (RCTs) investigated the effectiveness of psychological, pharmacological and combined treatments for chronic depression. This is the first overarching systematic review and network meta-analysis (NMA) based on aggregated and individual patient data comparing the efficacy and acceptability of various treatment options for all subtypes of chronic depression.

The Impact of Loneliness on Late-Life Depression and Anxiety During the COVID-19 Pandemic.

Objective: This study investigates the association of loneliness during the COVID-19 pandemic and the course of depressive, anxiety and sleep symptoms after psychological treatment in older adults.

Methods: During the first wave of the pandemic in 2020, we assessed additional, original data of 132 participants aged ≥60 years who had completed psychological treatment for late-life depression (LLD) in the context of a multicenter, randomized controlled trial (CBT-late). We measured loneliness using the UCLA Loneliness Scale.

Differential Psychological Treatment Effects in Patients With Late-Life Depression and a History of Childhood Maltreatment.

Objective: This is the first interventional study to assess the impact of childhood maltreatment (CM) on psychological treatment outcomes in patients with late-life depression (LLD).

Methods: This is a secondary analysis of a multicenter, randomized controlled trial with 251 participants aged ≥60 years with moderate to severe depression. Participants were randomly assigned to cognitive behavioral therapy for late life depression (LLD-CBT) or to a supportive intervention (SUI).

Algorithm-based modular psychotherapy vs. cognitive-behavioral therapy for patients with depression, psychiatric comorbidities and early trauma: a proof-of-concept randomized controlled trial.

Effect sizes of psychotherapies currently stagnate at a low-to-moderate level. Personalizing psychotherapy by algorithm-based modular procedures promises improved outcomes, greater flexibility, and a better fit between research and practice. However, evidence for the feasibility and efficacy of modular-based psychotherapy, using a personalized treatment algorithm, is lacking.

Perceived Physical Health and Cognitive Behavioral Therapy vs Supportive Psychotherapy Outcomes in Adults With Late-Life Depression: A Secondary Analysis of a Randomized Clinical Trial.

Importance: Physical diseases co-occur with late-life depression (LLD). The influence of physical diseases and the subjective perception of physical health (PPH) on treatment outcome in LLD, however, is not well understood.

Objective: To assess the association of physical diseases and PPH with the outcomes of 2 different types of psychotherapy in LLD.

Longitudinal Clusters of Long-Term Trajectories in Patients with Early-Onset Chronic Depression: 2 Years of Naturalistic Follow-Up after Extensive Psychological Treatment.

Introduction: In clinical trials, mostly group-level treatment effects of repeated cross-sectional measures are analyzed. However, substantial heterogeneity regarding individual symptom profiles and the variability of treatment effects are often neglected, especially over the long-term course. To provide effective personalized treatments, investigations of these characteristics are urgently needed.

Implications of the Network Theory for the Treatment of Mental Disorders: A Secondary Analysis of a Randomized Clinical Trial.

Importance: Conceptualizing mental disorders as latent entities has been challenged by the network theory of mental disorders, which states that psychological problems are constituted by a network of mutually interacting symptoms. While the implications of the network approach for planning and evaluating treatments have been intensively discussed, empirical support for the claims of the network theory regarding treatment effects is lacking.

Objective: To assess the extent to which specific hypotheses derived from the network theory regarding the (interindividual) changeability of symptom dynamics in response to treatment align with empirical data.

Cognitive Behavioral Therapy for Late-Life Depression (CBTlate): Results of a Multicenter, Randomized, Observer-Blinded, Controlled Trial.

Introduction: Different psychotherapeutic interventions for late-life depression (LLD) have been proposed, but their evaluation in large, multicenter trials is rare.

Objective: The present study evaluated the efficacy of a specific cognitive behavioral therapy (CBT) for LLD (LLD-CBT) in comparison with a supportive unspecific intervention (SUI), both administered in a specialist psychiatric outpatient setting.

Methods: In this randomized, controlled, parallel group trial, we recruited participants (≥60 years) with moderate to severe depression at 7 trial sites in Germany.

Effectiveness of Nature- and Animal Assisted Mindfulness for Relapse Prevention in Depressed Patients With a History of Childhood Maltreatment.

Background: For relapse prevention in depression, conventional mindfulness programs such as the mindfulness-based cognitive therapy proved to be useful. However, early life trauma is a risk factor for having adverse experiences during meditation. Thus, for this patient group mindfulness skills are often difficult to learn and may be facilitated by using animals and a nature setting.

Modular-based psychotherapy (MoBa) versus cognitive-behavioural therapy (CBT) for patients with depression, comorbidities and a history of childhood maltreatment: study protocol for a randomised controlled feasibility trial.

Introduction: In depression treatment, most patients do not reach response or remission with current psychotherapeutic approaches. Major reasons for individual non-response are interindividual heterogeneity of etiological mechanisms and pathological forms, and a high rate of comorbid disorders. Personalised treatments targeting comorbidities as well as underlying transdiagnostic mechanisms and factors like early childhood maltreatment may lead to better outcomes.

The Impact of Childhood Maltreatment on Long-Term Outcomes in Disorder-Specific vs. Nonspecific Psychotherapy for Chronic Depression.

Background: Childhood maltreatment (CM) predicted poorer outcomes in acute depression treatment with CBT, IPT and Supportive Psychotherapy (SP). The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) fared well in patients with chronic depression and CM during acute treatment, yet there is a considerable lack of empirical evidence for long-term outcomes.

Methods: We analyzed one and two-year follow-up data of 268 patients randomized to 24 sessions (20 weeks) of acute and 8 sessions (28 weeks) of extended treatment with CBASP or SP.

Interpersonal Psychotherapy vs. Treatment as Usual for Major Depression Related to Work Stress: A Pilot Randomized Controlled Study.

Depressive disorders are among the leading causes of sick leave and long-term work incapacity in most modern countries. Work related stress is described by patients as the most common context of depression. It is vital to know what types of treatments are effective in improving work related problems and occupational health.

Two-Year Follow-Up after Treatment with the Cognitive Behavioral Analysis System of Psychotherapy versus Supportive Psychotherapy for Early-Onset Chronic Depression.

Background: Evidence on the long-term efficacy of psychotherapeutic approaches for chronic depression is scarce.

Objective: To evaluate the effects of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) compared to Supportive Psychotherapy (SP) 1 year and 2 years after treatment termination.

Methods: In this study, we present 1- and 2-year follow-up assessments of a prospective, multicenter, evaluator-blinded, randomized clinical trial of outpatients with early-onset chronic major depression (n = 268).