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Psychotherapy with Depressed Outpatients: Patient and Process Variables as Predictors of Outcome

Published online by Cambridge University Press:  29 January 2018

Bruce J. Rounsaville
Affiliation:
Yale University Department of Psychiatry and Substance Abuse Treatment Unit, Connecticut Mental Health Center, 100 Park Street, New Haven, Connecticut 06511
Myrna M. Weissman
Affiliation:
Departments of Psychiatry and Epidemiology, Yale University, School of Medicine; Depression Research Unit, Connecticut Mental Health Center
Brigitte A. Prusoff
Affiliation:
Department of Psychiatry, Yale University School of Medicine, Depression Research Unit

Summary

This paper evaluates the predictive power of two classes of variables which are thought to be related to psychotherapy outcome: patient characteristics assessed at the start of treatment and process characteristics of the psychotherapy. The treatment was Short Term Interpersonal Psychoatherapy which was performed with ambulatory patients during a major depressive episode as defined by Research Diagnostic Criteria. Univariate correlations indicate that patients with generally healthier functioning on the Prognostic Index received better ratings on measures of psychotherapy process and experienced greater improvement in depressive symptoms and social functioning. However, in a multiple regression analysis, patient characteristics accounted for 64 per cent of the variance in treatment outcome, while psychotherapy process variables were not predictive of outcome.

Type
Research Article
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Auerbach, A. H. Luborsky, L. & Johnson, M. (1972) Clinician's predictions of outcome of psychotherapy: A trial of a prognostic index. American Journal of Psychiatry, 128, 830835.CrossRefGoogle ScholarPubMed
DiMascio, A. Klerman, G. L. Weissman, M. M. et al (in press) A control group for psychotherapy research in acute depression: One solution to ethical and methodological issues. Journal of Psychiatric Research.Google Scholar
DiMascio, A. Weissman, M. M. Prusoff, B. A. et al (1979) Differential symptom reduction by drugs and psychotherapy in acute depression. Archives of General Psychiatry, 36, 14501456.Google Scholar
Endicott, J. & Spitzer, R. L. (1978) A diagnostic interview. Archives of General Psychiatry, 35, 837844.Google Scholar
Frank, J. D. (1974) Persuasion and Healing. New York: Schocken.Google Scholar
Gomez-Schwartz, B. (1978) Effective ingredients in psychotherapy: Prediction of outcome from process variables. Journal of Consulting and Clinical Psychology, 46, 10231035.Google Scholar
Hamilton, M. (1960) A rating scale for depression. Journal of Neurological and Neurosurgical Psychiatry, 23, 5662.Google Scholar
Jacobson, S. Deykin, E. & Prusoff, B. A. (1977) Process and outcome of therapy with depressed women. American Journal of Orthopsychiatry, 47, 140148.CrossRefGoogle ScholarPubMed
Klerman, G. L. Rounsaville, B. J. Chevron, E. et al (1979) A manual for the short term interpersonal psychotherapy of depression, 4th revision.Google Scholar
Luborsky, L. (1976) Helping alliances in psychotherapy: The ground-work for a study of their relationship to its outcome. In Successful Psychotherapy (ed. Clagshorn, J. L.). New York: Brunner-Mazel.Google Scholar
Luborsky, L. Chandler, M. Aurerbach, A. H. Cohen, J. & Bachrach, H. (1971) Factors influencing the outcome of psychotherapy: A review of quantitative research. Psychological Bulletin, 75, 145185.Google Scholar
Luborsky, L. Mintz, J. Auerbach, A. Christoph, P. et al (1980) Predicting the outcome of psychotherapy: Findings of the Penn Psychotherapy Project. Archives of General Psychiatry, 37, 471481.CrossRefGoogle ScholarPubMed
Luborsky, L. Mintz, J. & Christoph, P. (1979) Are psychotherapeutic changes predictable? Comparison of a Chicago Counseling Center Project with a Penn Psychotherapy Project. Journal of Consulting and Clinical Psychology, 47, 469473.Google Scholar
Malan, D. H. (1976) Towards the Validation of Dynamic Psychotherapy: A Replication. New York: Plenum Medical Books.Google Scholar
Neu, C. Prusoff, B. & Klerman, G. (1978) Measuring the interventions used in the short term interpersonal psychotherapy of depression. American Journal of Orthopsychiatry, 48, 629636.Google Scholar
Prusoff, B. A. Weissman, M. M. Klerman, G. L. & Rounsaville, B. J. (1980) Research diagnostic criteria subtypes of depression: their role as predictors of differential response to psychotherapy and drug treatment. Archives of General Psychiatry, 37, 796801.CrossRefGoogle ScholarPubMed
Raskin, A. Schulterbrandt, J. Reatiq, N. et al (1969) Replication of factors of psychopathology in interview, ward behavior, and self-report ratings of hospitalized depressives. Journal of Nervous and Mental Disease, 148, 8798.Google Scholar
Sloane, R. B. Staples, F. R. Cristol, A. H. et al (1975) Psychotherapy vs. Behavior Therapy. Cambridge, Mass.: Harvard University Press.Google Scholar
Spitzer, R. L. Endicott, J. & Robins, E. (1978) Research diagnostic criteria. Archives of General Psychiatry, 36, 773782.Google Scholar
Strupp, A. H. & Hadley, S. W. (1979) Specific vs. nonspecific factors in psychotherapy. Archives of General Psychiatry, 36, 11251136.Google Scholar
Weissman, M. M. (1979) The psychological treatment of depression: Evidence for the efficacy of psychotherapy alone, in comparison with and in combination with pharmacotherapy. Archives of General Psychiatry, 36, 12611269.CrossRefGoogle ScholarPubMed
Weissman, M. M. & Paykel, E. (1974) The Depressed Woman: A Study of Social Relationships. University of Chicago Press.Google Scholar
Weissman, M. M. Prusoff, B. A. DiMascio, A. et al (1979) The efficacy of drugs and psychotherapy in the treatment of acute depressive episodes. American Journal of Psychiatry, 136, 555558.CrossRefGoogle ScholarPubMed
Zeiss, A. M. Lewinsohn, P. M. & Munoz, R. F. (1979) Non-specific improvement effects in depression using interpersonal skills, training, pleasant activities, scheduling or cognitive training. Journal of Consulting and Clinical Psychology, 47, 427439.Google Scholar
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