The Efficiency And Associated Factors Of Structured Group Cognitive Behavioral Therapy For Mild Depression, Minor Depressive Disorder And Dysthymia

ObjectiveMild depression,minor depressive disorder and dysthymia are common mood disorders.They have negative influence on patients’ social function and quality of life.But limited attention has been paid to these problems.Only a small part of these patients can be recognized in time and most of them do not get enough treatment.The present study was designed to compile a manual of structured group cognitive behavioral therapy(GCBT)and to find out those factors which might influence the effect of GCBT in order to provide a new option for these patients with mild depression,minor depressive disorder or dysthymia.Method1.A prospective self-control and case-control study was designed.Patients who were treated by group cognitive behavioral therapy(GCBT)would be evaluated at baseline on their clinical symptoms,general function,psychical and social factors,which would be repeated at different points of follow-up.For those patients who couldn’t join the GCBT group but would like to be included in the study,they would be considered as control group(Treatment as Usual,TAU)and compared to GCBTgroup.2.Each GCBT group included 6 to 8 patients.They would have12sessions(1.5 hours per session)in a frequency of once a week.The evaluation would be implemented at baseline,4 weeks,8 weeks and the end of the group treatment(12 weeks)as well as 24 weeks,36 weeks and48 weeks during follow-up period.3.Scales of HAMD-17,HAMA,GAF,SF-6,PSSS,ETISR-SF,TEMPS-A,TCSQ,MDQ,PGI-I were used to evaluate clinical symptoms,function and other related factors of patients recruited in the present study.4.All data analysis was based on the Intention-To-Treat analysis.Epidata3.0 was used to input data and SPSS19.0 to analyze them.The statistical methods included Chi-squared Test,Independent-samples T Test,Paired-samples T Test,One-way Analysis of Variance,Binary Logistics Regression and so on.Result1.One hundred and three patients with mild depression,minor depressive disorder or dysthymia were recruited in the present study.72 patients were included in GCBT group and 31 patients were included in group of TAU.There were no significant different in all the demographic characteristics between the two groups.2.The efficiency and feasibility of GCBT.Compared to the baseline,the scores of depression and anxiety at 4weeks,8 weeks,12 weeks,24 weeks,36 weeks and 48 weeks declined significantly,and the scores of quality of life increased significantly in GCBT group(P<0.05).Furthermore,the depressive score of GCBT group was significant different from that of TAU(P=0.019)by the end of 12 weeks.Compared to the baseline,scores of PSSS and positive coping strategy improved significantly at 48-week follow-up(P<0.05).Both in the periods of treatment and follow-up,the score of negative coping strategy declined significantly.There was a significant difference of cyclothymia between baseline and the period of follow-up(P<0.01).In the first 6 months,,above 90% patients reflected that theirdepressive symptoms improved during the treatment.The number declined to 86.5% after 6 months.Above 90% patients were satisfied with GCBT.3.Factors influenced the efficiency of GCBTAffective temperament of Cyclothymia(B=0.336,W=7.118,P=0.008),early sexual traumatized experience(B=2.025,Wals=7.050,P=0.008)and attendance of patients entered the final equation of Logistics Regression(B=-4.670,Wals=6.211,P=0.013),but different diagnoses and therapists did not.ConclusionStructured group cognitive behavioral therapy(GCBT)for Chinese patients with mild depression,minor depressive disorder or dysthymia has certain curative efficacy.Global impression and acceptance of patients are relatively high.Affective temperament of Cyclothymia,early sexual traumatized experience and attendance of patients can be predictors of GCBT.