Feasibility and effectiveness of cognitive behavioral analysis system of psychotherapy for chronically depressed inpatients: a pilot study

Abstract

Background

Cognitive Behavioral Analysis System of Psychotherapy (CBASP) was initially developed and evaluated as an outpatient treatment for chronic depression. Given the high degree of suicidality and comorbidity in chronic depression, however, many of these patients require prolonged inpatient treatment. Here, we report on a first specialized program for chronic depression adapting CBASP to an inpatient setting.

Methods

To evaluate feasibility and effectiveness of this program 30 chronically depressed inpatients were included in an open pilot study. The structured CBASP-based three-month inpatient program combined individual and group therapy sessions.

Results

The majority of the patients suffered from early onset depression, childhood trauma, and a high degree of axis-I and axis-II comorbidity. All patients completed the program perceiving the concept as very helpful. Pre-post comparisons showed significant changes with strong effect sizes. None of the patients deteriorated. In addition, CBASP specific instruments revealed that patients changed their stimulus-character and learned to perform the technique of Situational Analysis. 12 months follow up data show that most patients experienced no relapse.

Conclusion

The findings suggest that a CBASP inpatient program is a feasible and effective short- and longterm treatment for chronically depressed inpatients with high comorbidity rates. A prospective randomized controlled trial will be conducted to validate these promising pilot data.