title: Change in self-esteem predicts depressive symptoms at follow-up after intensive multimodal psychotherapy for major depression.
abstract: Reduced self-esteem is a core symptom of depression, but few studies have investigated within-treatment change of self-esteem as a predictor of long-term outcome in depression. This study investigated change in self-esteem during 8 weeks of multimodal, psychodynamically oriented psychotherapy for 40 depressed patients and tested whether it would predict outcome 6 months after termination. Data was drawn from a randomized clinical pilot trial on day-clinic versus inpatient psychotherapy for depression. Findings supported the association between change in self-esteem and follow-up depression severity, even when controlling for within-treatment symptom change. Change in self-esteem was not related to overall symptoms and interpersonal problems at follow-up. Thus, change in self-esteem may be an important variable in preventing relapse for depression.
  
  
  CONCLUSIONS
  Self-esteem is related to depressive symptoms and interpersonal problems. Improvement of self-esteem during psychotherapy correlates with improvements of symptoms and interpersonal problems. Change of self-esteem during psychotherapy predicts depressive symptoms 6 months after termination of therapy. When treating depressed patients, psychotherapists should work towards an improvement of self-esteem in order to prevent relapse.
authors.affiliation: General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Dinger
authors.affiliation: Department of Psychology, Klagenfurt University, Klagenfurt, Austria.
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Ehrenthal
authors.affiliation: General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Nikendei
authors.affiliation: General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Schauenburg
mesh_terms: D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy / Q000379:methods; D003865:Major Depressive Disorder / Q000523:psychology* / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D064889:Psychotherapy, Psychodynamic / Q000379:methods*; D012649:Self Concept; D012720:Severity of Illness Index; D016896:Treatment Outcome; D055815:Young Adult
keywords: inpatient treatment; mechanisms of change; psychodynamic psychotherapy; self-esteem