Evaluation of an outpatient intervention for women with severe depression and a history of childhood trauma.
OBJECTIVE
The study examined the effectiveness of a three-month structured outpatient intervention developed for women with severe depression and childhood trauma that used brief psychodynamic psychotherapy by comparing it to standard treatment recommended in clinical guidelines issued by the Chilean Ministry of Health.


METHODS
Eighty-seven women who sought treatment from a public health service in Curicó, Chile, and who had severe depression and a history of childhood traumatic experiences were randomly assigned to receive either the intervention (N=44) or standard treatment (N=43). The participants were assessed at baseline and at three months (completion of the intervention) and six months with use of the Hamilton Depression Scale (Ham-D); Lambert's Outcome Questionnaire (OQ-45.2), which rates psychiatric symptoms, interpersonal relationships, and social role functioning; and the Post-traumatic Stress Treatment Outcome scale (PTO 8), which assesses symptoms of posttraumatic stress disorder. An intent-to-treat design was used with multiple analyses of variance.


RESULTS
At three months significant differences were found in favor of the intervention group in Ham-D scores (p<.001) and OQ-45.2 scores (p<.05). At six months a significantly greater proportion of the intervention group had indicators of remission as measured by the OQ-45.2 (39% versus 14%, p<.05) and by the Ham-D (22% versus 5%, p<.05). Scores on the PTO 8 indicated significant improvements in posttraumatic stress disorder symptoms at six months, although there were no significant differences between the groups.


CONCLUSIONS
An outpatient intervention that screened for and focused on childhood traumas and that helped patients understand current psychosocial difficulties as a repetition of past traumas was effective in reducing psychiatric symptoms and improving interpersonal relationships and social role functioning among women with severe depression and a history of childhood trauma.
Vitriol
Verónica G
VG
Department of Mental Health, Curicó Hospital, 211 Chacabuco, Curicó 5675, Chile. vvitriol@hospitalcurico.cl
Ballesteros
Soledad T
ST
Florenzano
Ramón U
RU
Weil
Kristina P
KP
Benadof
Dafna F
DF
D000328:Adult; D000553:Ambulatory Care / Q000458:organization & administration*; D000928:Antidepressive Agents / Q000627:therapeutic use; D002648:Child; D002649:Child Abuse / Q000523:psychology / Q000628:therapy*; D002650:Child Abuse, Sexual / Q000523:psychology / Q000628:therapy*; D002677:Chile; D002908:Chronic Disease; D003131:Combined Modality Therapy; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007398:Interpersonal Relations; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011575:Psychoanalytic Therapy; D011594:Psychometrics; D011614:Psychotherapy, Brief; D012380:Role; D020377:Self Efficacy
D000928:Antidepressive Agents