Patients hospitalized with major depressive disorder who participated in a short-term psychoeducational program with cognitive behavioral group therapy in addition to normal inpatient treatment had a lower rehospitalization rate during a 2-year follow-up period, according to a study published in the Journal of Affective Disorders.
This randomized controlled study involved 177 patients who were randomly assigned to the 3 treatment interventions: extended clinical management (n=58), psychoeducational cognitive behavioral group therapy (n=59), or psychoeducational cognitive behavioral group therapy plus individual outpatient treatment (n=60). All patients received pharmacotherapy treatments, mainly antidepressants. Patients in the group receiving individual outpatient treatment attended sessions for 6 months following hospitalization. Outcomes between groups were compared for depressive symptoms, psychosocial functioning, knowledge about depression, and rehospitalization; outcome measures were collected at baseline, midway through treatment, post-treatment, and following hospital discharge every 6 months for 2 years.
Results of the trial indicate that all 3 treatment interventions were highly effective at reducing depressive symptoms and increasing psychosocial functioning. Knowledge about depression was significantly improved in both cognitive psychoeducational groups over the extended clinical management cohort. Rehospitalization rates were significantly lower for participants randomized to psychoeducational cognitive behavioral group therapy compared with patients receiving extended clinical management. However, patients who received the psychoeducation group intervention plus individual outpatient sessions had higher rehospitalization rates than patients in cognitive psychoeducation group therapy alone. Because the rate of rehospitalization was highest following the end of the 6-month individual therapy component for this cohort, study investigators suggest that termination of individual sessions may have been a stressor for relapsing patients.
Study findings show that a relatively short inpatient program involving psychoeducation cognitive behavioral group therapy for patients with major depression had a lasting effect on the information they learned about the illness and treatment adherence. These results are encouraging as the time-limited cognitive behavioral therapy and psychoeducation provided to hospitalized patients with depression showed both short- and long-term clinical benefits.
Schaub A, Goldmann U, Mueser TK, et al. Efficacy of extended clinical management, group CBT, and group plus individual CBT for major depression: Results of a two-year follow-up study. J Affect Disord. 2018; 238: 570-578.