Effect of cognitive-behavioral therapy after treatment for adults with major depression / Efeito da terapia cognitivo-comportamental um ano após tratamento para adultos com transtorno depressivo maior / Efecto de la terapia cognitiva comportamental un año después tratamiento para transtorno depresivo mayor

In Brazil, little is known about the maintenance of results after treatment of cognitive-behavioral therapy (CBT) for major depressive disorder (MDD). The objective of this study was to verify the effectiveness of individual psychotherapeutic treatment from CBT for depressive symptoms within 6 and 12 months after the intervention. We evaluated 94 participants with MDD from the Beck Depression Inventory (BDI-II). There was significant posttreatment response (p < 0.001), with no difference between the end of the treatment and the symptom assessment at 6 (p = 0.486) and 12 months (p = 0.098). A significant positive correlation was observed between the intensity of depressive symptoms at the baseline and the reduction of initial symptoms for 12-month follow-up (r = 0.49; p < 0.001). CBT significantly reduces depressive symptoms by maintaining this condition up to 12 months post-intervention without significant influence of other characteristics beyond the intensity of depressive symptoms at the beginning of the therapeutic process.

No Brasil, pouco se sabe sobre a manutenção dos resultados pós-tratamento da terapia cognitivo-comportamental (TCC) para o transtorno depressivo maior (TDM). Objetivou-se verificar a efetividade do tratamento psicoterápico individual a partir da TCC para os sintomas depressivos em um período de 6 e 12 meses pós-intervenção. Avaliaram-se 94 participantes com TDM a partir do Inventário Beck de Depressão (BDI-II). Houve resposta significativa pós-tratamento (p < 0,001), não ocorrendo diferenças entre o final do tratamento e a avaliação dos sintomas aos 6 (p = 0,486) e 12 meses (p = 0,098). Uma correlação positiva significativa foi observada entre a intensidade dos sintomas depressivos no baseline e a redução de sintomas iniciais para o acompanhamento de 12 meses (r = 0,49; p < 0,001). A TCC reduz significativamente os sintomas depressivos mantendo essa condição até 12 meses pós-intervenção sem influência significativa de outras características além da intensidade dos sintomas depressivos no início do processo terapêutico.

Este estudio verificó la efectividad del tratamiento psicoterápico individual a partir de la terapia cognitiva conductual (TCC) para los síntomas depresivos dentro de los 6 y 12 meses post-intervención. Se evaluaron 94 participantes con TDM a partir del Inventario Beck de depresión (BDI-II). Se observó una respuesta significativa post-tratamiento (p < 0,001), no ocurrieron diferencias entre el final del tratamiento y la evaluación de los síntomas a los 6 (p = 0,486) y 12 meses (p = 0,098). Había una correlación positiva significativa entre la intensidad de los síntomas depresivos en el baseline y la reducción de los síntomas iniciales para el seguimiento de 12 meses (r = 0,49; p < 0,001). La TCC reduce significativamente los síntomas depresivos manteniendo esa condición hasta 12 meses después de la intervención sin influencia significativa de otras características además de la intensidad de los síntomas depresivos al inicio del proceso terapéutico.

Psychoactive substance abuse and dependence and its association with anxiety disorders: a population-based study of young adults in Brazil

Objective: To evaluate the association between abuse of and dependence on different psychoactive substances and the presence of anxiety disorders in a sample of young adults from a city in southern Brazil. Methods: Between 2007 and 2009, we carried out a cross-sectional, population-based study of individuals aged 18-24 years who lived in Pelotas, a city in southern Brazil. We evaluated anxiety disorders using the Mini International Neuropsychiatric Interview 5.0 (MINI), and use of psychoactive substances with the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST 2.0/0MS). We used Fisher's exact test for univariate analysis, and Poisson regression models with robust variance for multivariable analysis. Results: The sample consisted of 1,560 young adults. The overall prevalence of abuse/dependence was 26.9% for alcohol, 24.9% for tobacco, and 7.3% for illicit substances. Individuals with agoraphobia had a 32% higher prevalence of tobacco abuse/dependence (prevalence ratio [PR] = 1.32 [95%CI 1.01-1.74]). Individuals with posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) had a 2.41-fold (95%CI 1.22-4.77) and 1.76-fold (95%CI 1.00-3.11) higher prevalence of illicit substance abuse/dependence, respectively. Conclusion: In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.

Effects of cognitive-behavioral therapy on neurotrophic factors in patients with major depressive disorder

Objective: To correlate neurotrophic factors - brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and beta-nerve growth factor (beta-NGF) - and severity of depressive symptoms in patients diagnosed with major depressive disorder (MDD) undergoing cognitive-behavioral therapy (CBT). Methods: In this quasi-experimental study, participants were selected by convenience and received 16 sessions of CBT. The outcomes of interest were severity of depressive symptoms and changes in neurotrophic factor levels after CBT. The differences between variables before and after treatment (deltas) were analyzed. Results: Patients had significant changes in symptom severity after treatment. No significant associations were found between Beck Depression Inventory II (BDI-II) scores and any independent variable. No correlations were observed between BDNF or GDNF levels and BDI scores before or after treatment, although there was a trend toward significant differences in beta-NGF levels. Conclusion: BDNF, beta-NGF, and GDNF were not influenced by the effects of CBT on depressive symptoms.

Effects of cognitive-behavioral therapy on neurotrophic factors in patients with major depressive disorder.

OBJECTIVE: To correlate neurotrophic factors - brain-derived neurotrophic factor (BDNF), glial cell line-derived neurotrophic factor (GDNF), and beta-nerve growth factor (beta-NGF) - and severity of depressive symptoms in patients diagnosed with major depressive disorder (MDD) undergoing cognitive-behavioral therapy (CBT). METHODS: In this quasi-experimental study, participants were selected by convenience and received 16 sessions of CBT. The outcomes of interest were severity of depressive symptoms and changes in neurotrophic factor levels after CBT. The differences between variables before and after treatment (deltas) were analyzed. RESULTS: Patients had significant changes in symptom severity after treatment. No significant associations were found between Beck Depression Inventory II (BDI-II) scores and any independent variable. No correlations were observed between BDNF or GDNF levels and BDI scores before or after treatment, although there was a trend toward significant differences in beta-NGF levels. CONCLUSION: BDNF, beta-NGF, and GDNF were not influenced by the effects of CBT on depressive symptoms.

Psychoactive substance abuse and dependence and its association with anxiety disorders: a population-based study of young adults in Brazil.

OBJECTIVE: To evaluate the association between abuse of and dependence on different psychoactive substances and the presence of anxiety disorders in a sample of young adults from a city in southern Brazil. METHODS: Between 2007 and 2009, we carried out a cross-sectional, population-based study of individuals aged 18-24 years who lived in Pelotas, a city in southern Brazil. We evaluated anxiety disorders using the Mini International Neuropsychiatric Interview 5.0 (MINI), and use of psychoactive substances with the Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST 2.0/0MS). We used Fisher's exact test for univariate analysis, and Poisson regression models with robust variance for multivariable analysis. RESULTS: The sample consisted of 1,560 young adults. The overall prevalence of abuse/dependence was 26.9% for alcohol, 24.9% for tobacco, and 7.3% for illicit substances. Individuals with agoraphobia had a 32% higher prevalence of tobacco abuse/dependence (prevalence ratio [PR] = 1.32 [95%CI 1.01-1.74]). Individuals with posttraumatic stress disorder (PTSD) or generalized anxiety disorder (GAD) had a 2.41-fold (95%CI 1.22-4.77) and 1.76-fold (95%CI 1.00-3.11) higher prevalence of illicit substance abuse/dependence, respectively. CONCLUSION: In this population-based sample, we found associations between GAD, PTSD, and increased prevalence of illicit substance abuse/dependence. In addition, individuals with agoraphobia seem to have increased tobacco abuse/dependence.