Quality of life in depression: An important outcome measure in an outpatient cognitive-behavioural therapy group programme?

2009 ◽  
Vol 16 (6) ◽  
pp. 485-496 ◽  
Author(s):  
Amanda Swan ◽  
Hunna J. Watson ◽  
Paula R. Nathan
Keyword(s):  
Quality Of Life ◽  
Cognitive Behavioural Therapy ◽  
Outcome Measure ◽  
Therapy Group ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Group Programme ◽  
Important Outcome Measure

An investigation into the efficacy of a cognitive behavioural therapy group for low self-esteem in a primary care setting

2018 ◽  
Vol 11 ◽  
Author(s):  
Sarah Beattie ◽  
David Beattie
Keyword(s):  
Primary Care ◽  
Cognitive Behavioural Therapy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Therapy Group ◽  
Self Esteem ◽  
Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Mood Group ◽  
Group Programme

AbstractSelf-esteem refers to how an individual appraises themselves and is associated with good mental health. A number of studies have identified the efficacy of cognitive behavioural therapy (CBT) in the treatment of low self-esteem based on the formulation and treatment trajectory developed by Fennell (1999). However, there has been little empirical enquiry into the efficacy of the programme delivered in primary care. The current study investigated the effectiveness of a CBT programme for low self-esteem delivered within primary care. Fifty-four participants attended a 9-week ‘Boost Your Mood’ group programme. Paired sample t-tests were conducted on pre- and post-group scores on measures of depression, anxiety and self-esteem. Results indicated that there were statistically significant improvements in levels of depression, anxiety and self-esteem post-treatment. Findings are consistent with the suggestion that group CBT may be effective at increasing levels of self-esteem and reducing levels of depression and anxiety when delivered in a primary care setting.

scholarly journals A Tailored, Therapist-Guided Internet-Based Cognitive Behavioral Intervention as an Addition to Care as Usual for Patients With Rheumatoid Arthritis: Economic Evaluation alongside an RCT (Preprint)

2018 ◽  
Author(s):  
Maaike Ferwerda ◽  
Sylvia van Beugen ◽  
Henriët van Middendorp ◽  
Henk Visser ◽  
Harald Vonkeman ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Usual Care ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Healthcare Use ◽  
Cognitive Behavioural ◽  
Related Quality ◽  
Health Related

BACKGROUND A chronic somatic condition, such as rheumatoid arthritis (RA), can significantly reduce health related quality of life due to psychological, social and physical consequences. Cognitive behavioural therapy can aid in improving outcomes for patients, for example in terms of disease trajectory, health care utilization, and workplace disability of patients. In recent years internet-based cognitive behavioural therapy has been proposed as an effective and efficient way to offer cognitive behavioural therapy and further implementation. However, little research has been conducted to support this proposition. OBJECTIVE To stimulate the implementation of effective treatment strategies for improving health-related quality of life (HRQoL) of patients with rheumatoid arthritis (RA), cost-benefit ratios are required to inform stake-holders. A cost-effectiveness study from a societal perspective was conducted alongside a randomized controlled trial on a tailored and therapist-guided internet-based cognitive behavioural intervention (ICBT) for patients with elevated levels of distress, as an addition to usual care alone. METHODS Data were collected at baseline/pre-intervention, 6 months/post-intervention, and three-monthly thereafter during one year follow-up. Effects were measured in quality-adjusted life years (QALYs) and costs from a societal perspective including healthcare sector costs (including healthcare use, medication, and intervention costs), patient travel costs for healthcare use, and costs associated with loss of labor. RESULTS The intervention improved quality of life compared to usual care alone (Δ QALYs= 0.059), but also led to higher costs (Δ= € 4.211,44), which reduced substantially when medication costs were left out of the equation (Δ= € 1.862,72). Most (93%) of the simulated ICERS were in the north-east quadrant, suggesting a high probability that the intervention is effective in improving HRQoL, but at a greater monetary cost for society compared to usual care alone. CONCLUSIONS A tailored and guided ICBT intervention as an addition to usual care for patients with RA with heightened distress was effective in gaining quality of life. Consequently, implementation of the ICBT into standard healthcare for patients with RA is recommended, yet further study into cost reductions in this population is warranted. CLINICALTRIAL National trial registry number:NTR2100

scholarly journals Economic evaluation of online computerised cognitive–behavioural therapy without support for depression in primary care: randomised trial

2010 ◽  
Vol 196 (4) ◽  
pp. 310-318 ◽  
Author(s):  
S. A. H. Gerhards ◽  
L. E. de Graaf ◽  
L. E. Jacobs ◽  
J. L. Severens ◽  
M. J. H. Huibers ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Cost Utility ◽  
Significant Group ◽  
Efficient Treatment ◽  
Cognitive Behavioural ◽  
The Cost

BackgroundEvidence about the cost-effectiveness and cost utility of computerised cognitive–behavioural therapy (CCBT) is still limited. Recently, we compared the clinical effectiveness of unsupported, online CCBT with treatment as usual (TAU) and a combination of CCBT and TAU (CCBT plus TAU) for depression. The study is registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre (ISRCTN47481236).AimsTo assess the cost-effectiveness of CCBT compared with TAU and CCBT plus TAU.MethodCosts, depression severity and quality of life were measured for 12 months. Cost-effectiveness and cost-utility analyses were performed from a societal perspective. Uncertainty was dealt with by bootstrap replications and sensitivity analyses.ResultsCosts were lowest for the CCBT group. There are no significant group differences in effectiveness or quality of life. Cost-utility and cost-effectiveness analyses tend to be in favour of CCBT.ConclusionsOn balance, CCBT constitutes the most efficient treatment strategy, although all treatments showed low adherence rates and modest improvements in depression and quality of life.

scholarly journals A Group Cognitive Behavioural Therapy Improves Quality of Life of Multiple Sclerosis Patients and Delays Disease Progression: A Multi-Centre Controlled Trial

2018 ◽  
Vol 1 (1) ◽  
pp. 77-84
Author(s):  
Richard Devy ◽  
Philip Lehert ◽  
Marc Genty
Keyword(s):  
Quality Of Life ◽  
Multiple Sclerosis ◽  
Disease Progression ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
Group Cognitive Behavioural Therapy ◽  
Cognitive Behavioural ◽  
Multiple Sclerosis Patients

Background: Multiple Sclerosis (MS) affects quality of life (QoL). Pharmacological treatments demonstrated benefits on clinical endpoints without improving QoL. We evaluated the effects of a group Cognitive Behavioural Therapy (CBT) on QoL disease progression. Methods: One-year multi-centre controlled multivariate-matched study was organised on Relapsing-Remitting MS (RRMS) patients with Expanded Disability Status Scale (EDSS) < 4, MS duration < 2 years, treated by interferon I? in 11 French centres. For each new patient, the two best-matching patients for age, gender, EDSS, mood, illness duration baseline variables were selected in the other centres. The self-filled Two Lives Scale (TLS)-QoL10 was used at months (M) 0-3-6-9-12-15; the post-baseline mean QoL was the endpoint. We compared CBT + I? to I? alone. The effect of disease progression on QoL was evaluated by modelling, for each visit, the effect of EDSS on QoL at later visits.Results: 19 + 32 patients were recruited. Compared to placebo, improvements of 1.10 (95%CI [0.31-1.89], p = 0.009) and 1.43*** [0.72, 2.15] were observed in the CBT group on QoL and coping scales, respectively. Coping explained 81%*** [57, 100] of the effect of CBT on QoL. QoL was negatively affected by disease progression (0.95*** [-1.21; 0.63]), whereas EDSS was influenced by QoL values (-0.10*** [-0.14; -0.06]).Conclusions: We observed a clinically significant beneficial effect of CBT on QoL, the effect of CBT essentially explained by an increase of coping, a positive influence of QoL on disease progression. QoL is both the most important target for patients and a factor of slowing disease progression.

scholarly journals Yoga, cognitive–behavioural therapy versus education to improve quality of life and reduce healthcare costs in people with endometriosis: a randomised controlled trial

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046603
Author(s):  
Antonina Mikocka-Walus ◽  
Marilla Druitt ◽  
Melissa O'Shea ◽  
David Skvarc ◽  
Jennifer J Watts ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomised Controlled Trial ◽  
Cognitive Behavioural Therapy ◽  
Controlled Trial ◽  
Behavioural Therapy ◽  
System Perspective ◽  
Cognitive Behavioural ◽  
Randomised Controlled ◽  
Weekly Group

IntroductionEndometriosis is a debilitating chronic inflammatory condition highly burdensome to the healthcare system. The present trial will establish the efficacy of (1) yoga and (2) cognitive–behavioural therapy (CBT), above (3) education, on quality of life, biopsychosocial outcomes and cost-effectiveness.Methods and analysisThis study is a parallel randomised controlled trial. Participants will be randomly allocated to yoga, CBT or education. Participants will be English-speaking adults, have a diagnosis of endometriosis by a qualified physician, with pain for at least 6 months, and access to internet. Participants will attend 8 weekly group CBT sessions of 120 min; or 8 weekly group yoga sessions of 60 min; or receive weekly educational handouts on endometriosis. The primary outcome measure is quality of life. The analysis will include mixed-effects analysis of variance and linear models, cost–utility analysis from a societal and health system perspective and qualitative thematic analysis.Ethics and disseminationEnrolment in the study is voluntary and participants can withdraw at any time. Participants will be given the option to discuss the study with their next of kin/treating physician. Findings will be disseminated via publications, conferences and briefs to professional organisations. The University’s media team will also be used to further disseminate via lay person articles and media releases.Trial registration numberACTRN12620000756921p; Pre-results.

P1561PREVALENCE OF DEPRESSION IN PATIENTS ON MAINTENANCE HAEMODIALYSIS AND FEASIBILITY OF GROUP BASED COGNITIVE BEHAVIOURAL THERAPY - A SINGLE CENTRE EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Ishthiaque Ahmed ◽  
Ganesh Srinivas ◽  
Diwakar Gooutham ◽  
Annapandian V. M
Keyword(s):  
Quality Of Life ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Single Centre ◽  
Maintenance Haemodialysis ◽  
Moderate Depression ◽  
Cognitive Behavioural ◽  
Dialysis Vintage ◽  
Prevalence Of Depression

Abstract Background and Aims The reported prevalence of depression in dialysis population ranges from 20-45%, which varies across regions. Limited data are available on association with co-morbidities, clinical symptoms and quality of life, especially from India. Present study was aimed to explore the prevalence of depression in patients on maintenance haemodialysis, quality of life and feasibility of group based cognitive behavioural therapy (CBT) in this set of patients. Method This is a single centre prospective study conducted at a tertiary care referral hospital, Bangalore, India, over the period of 22 months (Dec-2017 to Apr-2019). Patients aged &gt;18 years and on maintenance haemodialysis for &gt;6 months were included in the study. Any patients with known psychiatric illness or substance abuse were excluded. Beck depression inventory (BDI) score and quality of life by kidney disease quality of life short form-36 (KDQOL-SF) were used for diagnosis of depression. Group based CBT is offered to patients with mild to moderate depression. Results A total of 100 (85 males) patients were studied, the mean±SD age was 54.0±12.9 years (range, 23-76). Forty-six (46%) patients had depression (mean BDI score 35.04±10.8), out of whom, 8 (17.4%) had mild depression, 6 (13.1%) had moderate depression, 14 (30.4%) had severe depression and 18 (39.1%) people had extreme levels of depression. Females, unemployed and retired persons, low socioeconomic status and frequent dialysis related complications are more prone for depression. Age, dialysis vintage, duration from diagnosis to dialysis, associated co-morbid conditions, frequency of emergency dialysis requirement, hospitalization rates did not significantly differ in both groups. Low serum phosphate levels and high Kt/V values had association with depression, while haemoglobin, serum albumin and serum calcium levels did not have association with depression. We were unable to complete the group based CBT due to medical and social reasons. Conclusion Depression is common in haemodialysis patients, patients with depression had poor medication compliance and lower quality of life. Group based CBT is not feasible due to high attrition rates.

scholarly journals Group cognitive behavioural therapy (GCBT) versus treatment as usual (TAU) in the treatment of irritable bowel syndrome (IBS): a study protocol for a randomized controlled trial

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Shino Kikuchi ◽  
Yuki Oe ◽  
Yohei Sasaki ◽  
Hirono Ishii ◽  
Yuri Ito ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Irritable Bowel Syndrome ◽  
Cognitive Behavioural Therapy ◽  
Behavioural Therapy ◽  
Common Disease ◽  
Treatment As Usual ◽  
Cognitive Behavioural ◽  
Irritable Bowel ◽  
Time Required

Abstract Background Irritable bowel syndrome (IBS) is a common disease that affects the quality of life (QOL) and social functioning of sufferers. Visceral anxiety is currently considered a key factor in the onset and exacerbation of IBS, and cognitive-behavioural therapy (CBT) targeting visceral anxiety is thought to be effective. However, access to CBT is limited due to the lack of trained therapists, the substantial time required for therapy and the associated costs. Group CBT (GCBT) may solve some of these problems. We have therefore planned this trial to examine the efficacy of GCBT for IBS. Methods The trial is a two-armed, parallel group, open label, stratified block randomized superiority trial. The study group will consist of 112 participants (aged 18–75 years) with IBS (Rome-III or IV criteria). Participants will be randomly allocated 1:1 to (i) the intervention group: ten-week GCBT plus treatment as usual (TAU) or (ii) the control group: waiting list (WL) plus TAU. The co-primary outcomes are the change in IBS severity or disease-specific quality of life from baseline to week 13 which is 1 month after the end of treatment. The efficacy of GCBT for IBS will be examined through mixed-effects repeated-measures analysis. Discussion GCBT, if found effective, can address the issues of the shortage of therapists as well as the time required and the costs associated with individual CBT. Clinically, the findings will help make effective CBT programmes accessible to a large number of distressed IBS patients at lower costs. Theoretically, the results will clarify the relationship between IBS and psychological stress and will help elucidate the underlying mechanisms of IBS. Trial registration UMIN, CTR-UMIN000031710. Registered on March 13, 2018.

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