STEPPS for Borderline Personality Disorder: A Pragmatic Trial and Naturalistic Comparison With Noncompleters.

Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a group psychotherapy approach that is effective for patients with borderline personality disorder (BPD) in a public health care setting. The sample in this study comprised 118 outpatients with BPD who were asked to participate in a Spanish-adapted version of STEPPS for 18 months, a psychotherapy program that could be added to their usual psychiatric intervention. They were divided into an experimental group who participated in STEPPS, and a control group, who received treatment as usual. Several variables were collected and the Borderline Evaluation of Severity Over Time (BEST) scale was administered at pretest, Months 3 and 6, posttest (Month 18), and 2-year follow-up (Month 42), after which a post hoc data analysis was carried out. The STEPPS program improved the as-usual treatment provided previously, and the results were cost-effective. A higher educational level and good patient collaboration predicted better outcome.

Psychological Treatments Features and Outcomes in Spanish Public Mental Health Centres

Little outcomes research has been developed at public mental health care centres up to now, where however a huge percentage of population is treated. Our purpose was to describe features and outcomes of patients attending some public psychological consultations in order to be assessed and if needed treated, in Cantabria (Spain); this should aim at improving effectiveness and efficiency of our psychological treatments. Our sample was composed by all new users coming to 3 clinical psychologists’ consultations for 3.5 years (N= 1962). We measured several clinical, sociodemographic and outcome variables at the beginning of these treatments (pretest), at its end or 1 year after the start (postest), and at 1 and 2 years follow-ups after postest; these variables were collected in clinical interviews or through a telephone survey. Postest showed that 51.4% of patients improved their state after our psychotherapies, while 31.7% did not. For the first year after postest 67.1% of them had not visited any public mental health centre in our region, and 82.4% had not done it for the second year. Previous mental health treatments, sick leaves at work, organic illnesses, applied treatments, asking for a written report, the patient’s involvement into the referral and collaboration into therapy were the main predictive variables of outcomes (AU)

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Variables predictoras de los resultados de un programa de prevención secundaria de la depresión / Outcome predictors in a depression secondary prevention program

En este estudio se analizaron las variables predictoras de la eficacia, la efectividad y laeficiencia de tres intervenciones dirigidas a la prevención secundaria de trastornos depresivos:psicoterapia cognitivo-conductual, potenciación de los propios recursos personalesde los pacientes y apoyo social. La muestra fue de 60 sujetos con depresión moderada,que se asignaron aleatoriamente a los tres tratamientos experimentales y a un cuartogrupo control de lista de espera. Las intervenciones se llevaron a cabo en centros deatención primaria en formato grupal. Se midieron variables sociodemográficas,psicopatológicas, de calidad de vida y de asistencia a recursos especializados de saludmental en el pretest, el postest y dos seguimientos (6 y 12 meses). Los resultados muestranque las personas para las que resultan más eficaces estos tratamientos son aquéllasen rangos medios de gravedad psicopatológica, con un comportamiento ansioso-depresivode corta evolución, que muestran una buena adecuación social, cuentan con apoyo socialy no tienen antecedentes de problemas depresivos(AU)

On this study, predictorsof efficacy, effectiveness and eficiency of three depression secondary prevention interventionswere analysed: Cognitive-behavioral psychotherapy, reinforcing personal resources andsocial support. The sample was composed by 60 people with from-mild-to-moderatedepression, who were randomly assigned either to any of the treatments or to a forthcontrol group (waiting list). The interventions were developed in groups set at PrimaryCare Centres. Sociodemographic, psychopathology, quality of life and attendance to mentalhealth services variables were assessed at pretest, postest and two follow-up evaluations,6 and 12 months afterwards. These treatments have more efficacy on people in the middleof the psychopathological severity ranking, with symptoms mixed with anxiety, with arecent depression, with good social integration, with social support and without depressiontroubles in the past(AU)

Prevención secundaria de la depresión en atención primaria / Depression secondary prevention in primary care

En este estudio se analizaron la eficacia, efectividad y eficiencia en relación a la prevención secundaria de la depresión de tres intervenciones: terapia cognitivo-conductual, potenciación de recursos personales (atención selectiva a habilidades, sin entrenamiento) y apoyo social. La muestra fue de 60 sujetos con síntomas depresivos moderados, que se asignaron aleatoriamente a los tratamientos o a un grupo control (lista de espera). Las intervenciones se llevaron a cabo en Centros de Atención Primaria en formato grupal. Se midieron variables psicopatológicas, de calidad de vida y de asistencia a recursos especializados de salud mental en el pretest, el postest y dos seguimientos (6 y 12 meses). Resultados: la terapia cognitivoconductual y la potenciación de recursos son más eficaces, efectivas y eficientes que el apoyo social, y éste más que la lista de espera

In order to analyse efficacy, effectiveness and eficiency of several depression secondary prevention programs, three group interventions were developed in Primary Care Centres: cognitive-behavioral therapy, promotion of one’s coping resources therapy (just paying attention to abilities, without training) and social support. The sample was composed by 60 people with from-mild-to-moderate depressive symptoms, who were randomly assigned either to any of the treatments or to a control group (waiting list). Psychopatology, quality of life and attendance to mental health services variables were assessed at pretest, postest and two follow-up evaluations, 6 and 12 months afterwards. Outcomes: both therapies had more efficacy, effectiveness and eficiency compared to the social support group, and this one was better than the waiting list

[Depression secondary prevention in primary care]. / Prevención secundaria de la depresión en atención primaria.

UNLABELLED: In order to analyse efficacy, effectiveness and efficiency of several depression secondary prevention programs, three group interventions were developed in Primary Care Centres: cognitive-behavioral therapy, promotion of one's coping resources therapy (just paying attention to abilities, without training) and social support. The sample was composed by 60 people with from-mild-to-moderate depressive symptoms, who were randomly assigned either to any of the treatments or to a control group (waiting list). Psychopathology, quality of life and attendance to mental health services variables were assessed at pretest, posttest and two follow-up evaluations, 6 and 12 months afterwards. OUTCOMES: both therapies had more efficacy, effectiveness and efficiency compared to the social support group, and this one was better than the waiting list.