The impact of childhood maltreatment on the differential efficacy of CBASP versus escitalopram in patients with chronic depression: A secondary analysis

Bausch Paul; Fangmeier Thomas; Zobel Ingo; Schoepf Dieter; Drost Sarah; Schnell Knut; Walter Henrik; Berger Mathias; Normann Claus; Schramm Elisabeth

摘要

>Childhood maltreatment (CM) has been indicated as a predictor of a differential response to antidepressant treatment with psychotherapy compared to medication. In this secondary analysis, we investigated whether the presence of CM results in a differential indication for the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) or escitalopram plus clinical management (ESC). Sixty patients with chronic depression were randomized to either 22 sessions of CBASP or ESC over the course of 8?weeks of acute and 20?weeks of extended treatment at 2 German treatment sites. CM was assessed using the Childhood Trauma Questionnaire and the clinician rated Early Trauma Inventory. Intention‐to‐treat analyses were used to examine the impact of CM on depression, global functioning, and quality of life. The presence of CM did not result in significant differences in treatment response to CBASP or ESC on any outcome measure after 28?weeks of treatment independent of the type of CM assessment. After 8?weeks, a significant CM?×?treatment interaction was found for scores on the Montgomery‐Asberg Depression Rating Scale. Patients with a history of CM receiving CBASP had a significantly lower response rate compared to patients without CM and to those receiving ESC after 8?weeks. Conclusively, CBASP and ESC are equally effective treatment options for the difficult to treat subgroup of patients with chronic depression and a history of CM. CM may be a predictor of a longer latency of treatment response in the case of psychotherapy.

Key Practitioner Message > <list style="bulleted" xml:id="cpp2081-list-0001"> <listItem xml:id="cpp2081-li-0001">CBASP and escitalopram are equally effective treatment options for chronic depression.</listItem> <listItem xml:id="cpp2081-li-0002">Both treatments are also equally effective for the difficult to treat subgroup of patients with chronic depression and a history of childhood maltreatment.</listItem> <listItem xml:id="cpp2081-li-0003">Childhood maltreatment may result in a longer latency of treatment response in the case of psychotherapy.</listItem> </list> </section> </abstract> </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> <div class="translation abstracttxt"> <span class="zhankaihshouqi fivelineshidden" id="abstract"> <span>机译：</span><abstract xmlns =“http://www.wiley.com/namespaces/wiley”type =“main”> <部分xml：id =“cpp2081-sec-1001”编号=“no”> >儿童虐待（与药物相比，CM）已被指示为对心理治疗的抗抑郁治疗的差异反应的预测因子。在该二次分析中，我们研究了CM是否存在对心理治疗（CBASP）或escitalopram加临床管理（ESC）的认知行为分析系统的差异指示。在8个急性和20周的急性和20周的延长治疗的过程中，患有六十岁的慢性抑郁症患者的CBASP或ESC的22个患者随机化。使用儿童创伤问卷和临床医生评估早期创伤库存评估CM。用于治疗分析来检查CM对抑郁症，全球运作和生活质量的影响。 CM的存在并未导致CMASPASP或ESC治疗响应的显着差异在28次治疗后的任何结果测量上，与CM评估的类型无关。 8. 8个星期后，有显着的厘米？××α？治疗相互作用被发现在蒙哥马利 - Asberg抑郁率等级上的分数。患有CM接受CBASP的患者与没有CM的患者相比具有显着较低的反应速率，并且在8个周后接受ESC的患者。结论，CBASP和ESC是难以治疗慢性抑郁患者的亚组和厘米历史的同等有效的治疗选择。在心理疗法的情况下，CM可以是较长延迟的预测因子。</ p> </段> <部分XML：ID =“CPP2081-SEC-1002”编号=“否”> <标题类型=“主要“>关键从业者消息</ tite> > > > > > > > > <list style =”bulleted“xml：id =”cpp2081-list-0001“> <listitem xml：id =”cpp2081-li-0001“> cbasp和escitalopram同样有效的慢性抑郁治疗选择。</ listitem> <listitem XML：ID =“CPP2081-LI-0002”>两种治疗也同样有效地治疗慢性抑郁患者患者的亚组和儿童虐待病史。 </ listitem> <listitem XML：ID =“CPP2081-LI-0003”>儿童虐待可能导致心理治疗的情况下的治疗响应延迟。</ listitem> </ list> </ p> </部分> </ abstract> </span> <span class="z_kbtn z_kbtnclass hoverxs" style="display: none;">展开▼</span> </div> </div> <div class="record"> <h2 class="all_title" id="enpatent33" >著录项</h2> <ul> <li> <span class="lefttit">来源</span> <div style="width: 86%;vertical-align: text-top;display: inline-block;"> <a href='/journal-foreign-16678/'>《Clinical Psychology & Psychotherapy》</a> <b style="margin: 0 2px;">|</b><span>2017年第5期</span><b style="margin: 0 2px;">|</b><span>共8页</span> </div> </li> <li> <div class="author"> <span class="lefttit">作者</span> <p id="fAuthorthree" class="threelineshidden zhankaihshouqi"> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Bausch Paul&option=202" target="_blank" rel="nofollow">Bausch Paul;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Fangmeier Thomas&option=202" target="_blank" rel="nofollow">Fangmeier Thomas;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Zobel Ingo&option=202" target="_blank" rel="nofollow">Zobel Ingo;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Schoepf Dieter&option=202" target="_blank" rel="nofollow">Schoepf Dieter;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Drost Sarah&option=202" target="_blank" rel="nofollow">Drost Sarah;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Schnell Knut&option=202" target="_blank" rel="nofollow">Schnell Knut;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Walter Henrik&option=202" target="_blank" rel="nofollow">Walter Henrik;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Berger Mathias&option=202" target="_blank" rel="nofollow">Berger Mathias;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Normann Claus&option=202" target="_blank" rel="nofollow">Normann Claus;</a> <a href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Schramm Elisabeth&option=202" target="_blank" rel="nofollow">Schramm Elisabeth;</a> </p> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zkzz" style="display: none;">展开▼</span> </div> </li> <li> <div style="display: flex;"> <span class="lefttit">作者单位</span> <div style="position: relative;margin-left: 3px;max-width: 639px;"> <div class="threelineshidden zhankaihshouqi" id="fOrgthree"> <p>Department of Psychiatry Faculty of MedicineUniversity of FreiburgFreiburg Germany;</p> <p>Department of Psychiatry Faculty of MedicineUniversity of FreiburgFreiburg Germany;</p> <p>Psychology SchoolFresenius University of Applied Sciences BerlinBerlin Germany;</p> <p>Department of Psychiatry and PsychotherapyUniversity of BonnBonn Germany;</p> <p>Psychology SchoolFresenius University of Applied Sciences CologneCologne Germany;</p> <p>Department of General PsychiatryUniversity Hospital HeidelbergHeidelberg Germany;</p> <p>Department of Psychiatry and PsychotherapyUniversity Medical Center Charité BerlinBerlin Germany;</p> <p>Department of Psychiatry Faculty of MedicineUniversity of FreiburgFreiburg Germany;</p> <p>Department of Psychiatry Faculty of MedicineUniversity of FreiburgFreiburg Germany;</p> <p>Department of Psychiatry Faculty of MedicineUniversity of FreiburgFreiburg Germany;</p> </div> <span class="z_kbtnclass z_kbtnclassall hoverxs" id="zhdw" style="display: none;">展开▼</span> </div> </div> </li> <li > <span class="lefttit">收录信息</span> <span style="width: 86%;vertical-align: text-top;display: inline-block;"></span> </li> <li> <span class="lefttit">原文格式</span> <span>PDF</span> </li> <li> <span class="lefttit">正文语种</span> <span>eng</span> </li> <li> <span class="lefttit">中图分类</span> <span><a href="https://www.zhangqiaokeyan.com/clc/5893.html" title="医学心理学">医学心理学;</a></span> </li> <li class="antistop"> <span class="lefttit">关键词</span> <p style="width: 86%;vertical-align: text-top;"> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Childhood Maltreatment&option=203" rel="nofollow">Childhood Maltreatment;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Chronic Depression&option=203" rel="nofollow">Chronic Depression;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Cognitive Behavioral Analysis System of Psychotherapy&option=203" rel="nofollow">Cognitive Behavioral Analysis System of Psychotherapy;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Escitalopram&option=203" rel="nofollow">Escitalopram;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Medication&option=203" rel="nofollow">Medication;</a> <a style="color: #3E7FEB;" href="/search.html?doctypes=4_5_6_1-0_4-0_1_2_3_7_9&sertext=Psychotherapy&option=203" rel="nofollow">Psychotherapy;</a> </p> <div class="translation"> 机译：儿童虐待;慢性抑郁;心理治疗的认知行为分析系统;escitalopram;药物;心理治疗; </div> </li> </ul> </div> </div> <div class="literature cardcommon"> <div class="similarity "> <h3 class="all_title" id="enpatent66">相似文献</h3> <div class="similaritytab clearfix"> <ul> <li class="active" >外文文献</li> <li 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