Nice study on the long-term outcomes of chronically depressed patients after cognitive-behavioral analysis (CBASP) or supportive therapy. The researchers found that only 16% of patients achieved stable long-term remission, another 37% had mild residual symptoms. - ThreadSky

tkaiser.science • 432 days ago

Nice study on the long-term outcomes of chronically depressed patients after cognitive-behavioral analysis (CBASP) or supportive therapy. The researchers found that only 16% of patients achieved stable long-term remission, another 37% had mild residual symptoms.

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tkaiser.science•432 days ago

The rest of the patients either had major depressive symptoms or fluctuated. The type of therapy did not seem to have any influence on the outcomes. Interesting to see the use of the LIFE interview to get a clearer picture of long-term outcomes.

https://www.researchgate.net/profile/Moritz_Elsaesser/publication/376893913_Longitudinal_Clusters_of_Long-Term_Trajectories_in_Patients_with_Early-Onset_Chronic_Depression_2_Years_of_Naturalistic_Follow-Up_after_Extensive_Psychological_Treatment/links/658e950d0bb2c7472b1d802f/Longitudinal-Clusters-of-Long-Term-Trajectories-in-Patients-with-Early-Onset-Chronic-Depression-2-Years-of-Naturalistic-Follow-Up-after-Extensive-Psychological-Treatment.pdf

tkaiser.science•432 days ago

Most of the patients reported traumatic childhood experiences. However, they did not receive trauma-focused therapy (and no, I don't consider CBASP trauma-focused). So I'll give you the following hot take: many chronic depressives are actually chronic trauma patients.

tkaiser.science•432 days ago

EMDR was superior to CBT for treatment-resistant depression in this (small) trial. Not sure if there are other ones, maybe @AdJongh knows.

https://www.frontiersin.org/articles/10.3389/fpsyg.2018.00074/full

blackwellse.bsky.social•431 days ago

V. interesting - I think it's a more general transdiagnostic point (e.g. https://link.springer.com/article/10.1007/s41811-021-00102-0): if people are experiencing distressing/impairing intrusive imagery (e.g. memories/ flashforwards), it makes sense to target this directly in treatment regardless of diagnosis.

blackwellse.bsky.social•431 days ago

e.g. in depression intrusive negative imagery is common, not necessarily ‘trauma’ as defined for PTSD, but v. distressing and potentially encapsulating/maintaining negative core beliefs, e.g. https://doi.org/10.1146/annurev-clinpsy-021815-092925

blackwellse.bsky.social•431 days ago

There have been some promising small-scale studies of imagery-rescripting (e.g. https://www.sciencedirect.com/science/article/abs/pii/S0005791623000216, https://doi.org/10.1016/j.jbtep.2021.101721 , https://www.sciencedirect.com/science/article/abs/pii/S0005796709000801), albeit all preliminary work.

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