title: Cognitive behavioral analysis system of psychotherapy versus interpersonal psychotherapy for early-onset chronic depression: a randomized pilot study.
abstract: BACKGROUND
  The only psychotherapy specifically designed and evaluated for the treatment of chronic depression, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP), has never been directly compared to another depression-specific psychological method.
  
  
  METHODS
  Thirty patients with early-onset chronic depression were randomized to 22 sessions of CBASP or Interpersonal Psychotherapy (IPT) provided in 16 weeks. Primary outcome was the score on the 24-item Hamilton Rating Scale for Depression (HRSD) assessed posttreatment by an independent blinded evaluator. Secondary endpoints were, among others, remission (HRSD≤8) rates and the Beck Depression Inventory (BDI). The study included a prospective naturalistic 12-month follow-up.
  
  
  RESULTS
  Intent-to-treat analyses of covariance (ANCOVA) revealed that there was no significant difference in posttreatment HRSD scores between the CBASP and the IPT condition, but in self-rated BDI scores. We found significantly higher remission rates in the CBASP (57%) as compared to the IPT (20%) group. One year posttreatment, no significant differences were found in the self-reported symptom level (BDI) using ANCOVA.
  
  
  CONCLUSIONS
  The study used only a small sample size and no placebo control. The generalizability of the results may be limited to patients with a preference for psychological treatment.
  
  
  CONCLUSIONS
  While the primary outcome was not significant, secondary measures showed relevant benefits of CBASP over IPT. We found preliminary evidence that in early-onset chronic depression, an approach specifically designed for this patient population was superior to a method originally developed for the treatment of acute depressive episodes. Long-term results suggest that chronically depressed patients may need extended treatment courses.
authors.affiliation: Department of Psychiatry and Psychotherapy, University Medical Centre Freiburg, Germany. Elisabeth.Schramm@uniklinik-freiburg.de
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Schramm
authors.forename: Ingo
authors.initials: I
authors.lastname: Zobel
authors.forename: Petra
authors.initials: P
authors.lastname: Dykierek
authors.forename: Sabine
authors.initials: S
authors.lastname: Kech
authors.forename: Eva-Lotta
authors.initials: EL
authors.lastname: Brakemeier
authors.forename: Anne
authors.initials: A
authors.lastname: Külz
authors.forename: Mathias
authors.initials: M
authors.lastname: Berger
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D003866:Depressive Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012074:Remission Induction; D016896:Treatment Outcome; D055815:Young Adult