Evaluation of an outpatient intervention for women with severe depression and a history of childhood trauma.
Psychiatr Serv
; 60(7): 936-42, 2009 Jul.
Article
in En
| MEDLINE
| ID: mdl-19564224
ABSTRACT
OBJECTIVE:
The study examined the effectiveness of a three-month structured outpatient intervention developed for women with severe depression and childhood trauma that used brief psychodynamic psychotherapy by comparing it to standard treatment recommended in clinical guidelines issued by the Chilean Ministry of Health.METHODS:
Eighty-seven women who sought treatment from a public health service in Curicó, Chile, and who had severe depression and a history of childhood traumatic experiences were randomly assigned to receive either the intervention (N=44) or standard treatment (N=43). The participants were assessed at baseline and at three months (completion of the intervention) and six months with use of the Hamilton Depression Scale (Ham-D); Lambert's Outcome Questionnaire (OQ-45.2), which rates psychiatric symptoms, interpersonal relationships, and social role functioning; and the Post-traumatic Stress Treatment Outcome scale (PTO 8), which assesses symptoms of posttraumatic stress disorder. An intent-to-treat design was used with multiple analyses of variance.RESULTS:
At three months significant differences were found in favor of the intervention group in Ham-D scores (p<.001) and OQ-45.2 scores (p<.05). At six months a significantly greater proportion of the intervention group had indicators of remission as measured by the OQ-45.2 (39% versus 14%, p<.05) and by the Ham-D (22% versus 5%, p<.05). Scores on the PTO 8 indicated significant improvements in posttraumatic stress disorder symptoms at six months, although there were no significant differences between the groups.CONCLUSIONS:
An outpatient intervention that screened for and focused on childhood traumas and that helped patients understand current psychosocial difficulties as a repetition of past traumas was effective in reducing psychiatric symptoms and improving interpersonal relationships and social role functioning among women with severe depression and a history of childhood trauma.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Psychoanalytic Therapy
/
Psychotherapy, Brief
/
Child Abuse, Sexual
/
Child Abuse
/
Depressive Disorder, Major
/
Ambulatory Care
Type of study:
Clinical_trials
/
Guideline
/
Observational_studies
/
Prognostic_studies
/
Qualitative_research
/
Risk_factors_studies
Limits:
Adult
/
Child
/
Female
/
Humans
/
Middle aged
Country/Region as subject:
America do sul
/
Chile
Language:
En
Journal:
Psychiatr Serv
Journal subject:
PSIQUIATRIA
Year:
2009
Document type:
Article
Affiliation country:
Chile