title: The effectiveness of the cognitive behavioral analysis system of psychotherapy for chronic depression: a randomized controlled trial.
abstract: BACKGROUND
  It is widely agreed that chronic depression is difficult to treat, knowledge about optimal treatment approaches is emerging.
  
  
  METHODS
  A multisite randomized controlled trial was conducted comparing the cognitive behavioral analysis system of psychotherapy (CBASP), a psychotherapy model developed specifically to treat chronic depression (n = 67) with care as usual (CAU; evidence-based treatments, n = 72) over a period of 52 weeks, with 23 sessions on average, in 3 outpatient clinics in the Netherlands. In both arms algorithm-based pharmacotherapy was provided. Patients (aged 18-65) met criteria for a DSM-IV diagnosis of major depressive disorder with diagnostic specifiers (chronic, without interepisode recovery) or with co-occurring dysthymic disorder indicating a chronic course. The Inventory for Depressive Symptomatology (IDS) Self-Report was used as the primary outcome measure. Mixed-effects linear regression analysis was used to compare the changes on the IDS scores between CBASP and CAU. The IDS was administered before treatment, and after 8, 16, 32 and 52 weeks.
  
  
  RESULTS
  At week 52, patients assigned to CBASP had a greater reduction of depressive symptoms compared to patients assigned to CAU (t = -2.00, p = 0.05). However, CBASP and CAU did not differ from each other on the IDS after 8 weeks (t = 0.49, p = 0.63), 16 weeks (t = -0.03, p = 0.98) and 32 weeks (t = -0.17, p = 0.86) of treatment.
  
  
  CONCLUSIONS
  This trial shows that CBASP is at least as effective as standard evidence-based treatments for chronic depression. In the long run, CBASP appears to have an added effect.
authors.affiliation: Department of Psychiatry and EMGO+ Institute for Health and Care Research, VU University Medical Center and GGZinGeest, Amsterdam, The Netherlands.
authors.forename: Jenneke E
authors.initials: JE
authors.lastname: Wiersma
authors.forename: Digna J F
authors.initials: DJ
authors.lastname: Van Schaik
authors.forename: Adriaan W
authors.initials: AW
authors.lastname: Hoogendorn
authors.forename: Jack J
authors.initials: JJ
authors.lastname: Dekker
authors.forename: Hendrikus L
authors.initials: HL
authors.lastname: Van
authors.forename: Robert A
authors.initials: RA
authors.lastname: Schoevers
authors.forename: Marc B J
authors.initials: MB
authors.lastname: Blom
authors.forename: Kristel
authors.initials: K
authors.lastname: Maas
authors.forename: Johannes H
authors.initials: JH
authors.lastname: Smit
authors.forename: James P
authors.initials: JP
authors.lastname: McCullough
authors.forename: Aartjan T F
authors.initials: AT
authors.lastname: Beekman
authors.forename: Patricia
authors.initials: P
authors.lastname: Van Oppen
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003863:Depression / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D016896:Treatment Outcome