Comparison of behavioral activation therapy and treatment as usual among depressed patients in secondary psychiatric care

Abstract

Introduction

Evidence-based brief therapies are needed to reduce a marked heterogeneity affecting treatment of depression within the public psychiatric care. They should be easy to implement and use for a large group of patients.

Objectives

To develop and implement an effective brief treatment protocol for depressed patients treated in public psychiatric secondary care.

Aim

To explore and compare the outcome of depressed patients receiving either behavioral activation therapy (BA) or treatment as usual (TAU).

Methods

Two hundred and forty two depressive patients referred to adult public secondary psychiatric care formed the BA treated study group. The TAU treated control group (n = 205) was collected from the hospital districts database and matched by the hospitalization rate, Alcohol Use Disorders Identification Test (AUDIT) and Beck Depression Inventory (BDI). All patients received anti-depressive medications. In the study group, Montgomery–Åsberg Depression Rating Scale (MADRS) was conducted four times within 24 months follow-up. In both groups, the ability of functioning was controlled by Global Assessment of Functioning scale (GAF).

Results

In the study group, depressive symptoms alleviated systematically and significantly during follow-up (Table 1). The improvement in GAF scores was significantly better in the study group throughout the follow-up (Table 1).

Conclusions

BA can be implemented and used effectively for depressive patients in public psychiatric secondary care. BA is superior to TAU in terms of functional recovery.

Table 1

¹Mean change (decrease) in Montgomery–Åsberg Depression Rating Scale (MADRS) compared to baseline.

²Mean score in Global Assessment of Functioning scale (GAF) during the given follow-up period.

³Within study groups compared to baseline.

⁴Between groups.

Disclosure of interest

The authors have not supplied their declaration of competing interest.