Effectiveness of and Dropout from Outpatient Cognitive Behavioral Therapy for Adult Unipolar Depression: A Meta-Analysis of Nonrandomized Effectiveness Studies

Autor/inn/en	Hans, Eva; Hiller, Wolfgang
Titel	Effectiveness of and Dropout from Outpatient Cognitive Behavioral Therapy for Adult Unipolar Depression: A Meta-Analysis of Nonrandomized Effectiveness Studies
Quelle	In: Journal of Consulting and Clinical Psychology, 81 (2013) 1, S.75-88 (14 Seiten) PDF als Volltext Verfügbarkeit
Sprache	englisch
Dokumenttyp	gedruckt; online; Zeitschriftenaufsatz
ISSN	0022-006X
DOI	10.1037/a0031080
Schlagwörter	Dropouts; Outcomes of Treatment; Therapy; Depression (Psychology); Cognitive Restructuring; Severity (of Disability); Patients; Effect Size; Dropout Rate; Meta Analysis; Behavior Modification; Clinical Diagnosis; Control Groups + Suchen Sie Ihr Suchwort? Drop-out; Drop-outs; Dropout; Early leavers; Schulversagen; Therapie; Schweregrad; Patient; Meta-analysis; Metaanalyse; Behaviour modification; Verhaltensänderung
Abstract	Objective: The primary aim of this study was to assess the overall effectiveness of and dropout from individual and group outpatient cognitive behavioral therapy (CBT) for adults with a primary diagnosis of unipolar depressive disorder in routine clinical practice. Method: We conducted a random effects meta-analysis of 34 nonrandomized effectiveness studies on outpatient individual and group CBT for adult unipolar depressive disorder. Standardized mean gain effect sizes are reported for end-of-treatment and 6-month follow-up effects for depression severity, dysfunctional cognitions, general anxiety, psychological distress, and functional impairment. The mean dropout rate from CBT is reported. We benchmarked our results against high-quality randomized controlled trials (RCTs). Results: Outpatient CBT was effective in reducing depressive severity in completer (d = 1.13) and intention-to-treat (ITT) samples (d = 1.06). Moderate to large posttreatment effect sizes (d = 0.67-0.88) were found for secondary outcomes. The weighted mean dropout rate was 24.63%. Posttreatment gains for depression were maintained at 6 months after completion of therapy. Effect sizes for depression were inferior to those of benchmark RCTs. Conclusions: Although clinical practice patients show lesser improvements in depressive symptoms than RCT patients, individual and group outpatient CBT can be effectively transported to routine clinical practice. The considerable treatment dropout rate, especially in individual CBT, must be improved. The small number of available studies and low quality of some reports stress the need for high-quality effectiveness studies. (Contains 2 tables and 2 figures.) (As Provided).
Anmerkungen	American Psychological Association. Journals Department, 750 First Street NE, Washington, DC 20002-4242. Tel: 800-374-2721; Tel: 202-336-5510; Fax: 202-336-5502; e-mail: order@apa.org; Web site: http://www.apa.org/publications
Erfasst von	ERIC (Education Resources Information Center), Washington, DC
Update	2017/4/10