Els Heene

The effects on mood of adjunctive single-family and multi-family group therapy in the treatment of hospitalized patients with major depression. A 15-month follow-up study.

Background: Family-based interventions have been shown to be effective in the treatment of depression, but they have seldom been studied in hospitalized depressed patients. This study assesses the value of the additional use of single-family or multi-family group therapy within this patient population. Methods: Eighty-three patients were randomly assigned to: (1) the treatment programme as usual (n = 23), (2) treatment as usual combined with single-family therapy (n = 25) or (3) treatment as usual combined with multi-family group therapy (n = 35). Follow-up assessments were made at 3 months and 15 months. Results: Multi-family group and single-family therapy conditions showed significantly higher rates of treatment responders than the group receiving the usual treatment (49, 24 and 9%, respectively), and higher rates of patients no longer using antidepressant medication (26, 16 and 0%, respectively) at 15 months. Partners taking part in the family treatments were significantly more likely to notice the improvements in the emotional health of the patient early on compared to those in the treatment as usual condition. Conclusions: This study suggests that single-family and multi-family therapy may benefit hospitalized patients with major depression, and may help the partners of the patients to become aware of the patient’s improvement more quickly.

Marital satisfaction, conflict communication, attachment style and psychological distress in couples with a hospitalized depressed patient

Background: There has been fairly consistent empirical support for the association between major depressive disorder and marital dissatisfaction. However, this evidence is limited mostly to out-patient and population-based samples. Further, the role of possible mediating factors such as attachment style and conflict communication are less well investigated in major depression. Objective: The present study aims to investigate whether couples with a depressed partner and nonclinical couples differ in marital satisfaction, attachment style, psychological distress and conflict communication. Gender differences are also investigated. Methods: Seventy-seven couples, who participated in a family intervention trial, were compared with 77 age- and gender-matched nonclinical couples. Results: The depressed patients reported more psychological distress and attachment difficulties and less marital satisfaction than their partners and the nonclinical couples. Partners perceived their relationship as more satisfying than the nonclinical couples. The clinical couples reported less mutual constructive and more mutual avoidant communication in their relationship compared with the nonclinical couples. Finally, female depressed patients reported higher levels of psychological symptoms and were more avoidant attached than male patients. Conclusions: This study shows important differences in several individual and relational characteristics between couples with a depressed partner and nonclinical couples. Further research will be necessary to clarify whether the investigated psychosocial variables play a causal and/or a maintaining role in depression.

Does Negative Mood Influence Self-Report Assessment of Individual and Relational Measures? An Experimental Analysis.

The present study was designed to test the influence of negative mood on the self-report of individual and relational correlates of depression and marital distress. The authors applied a combined experimental mood induction procedure, based on music, autobiographical recall, and environmental manipulation. Results showed that the mood manipulation was effective, and the depressed Mood Induction Procedure (MIP) and neutral MIP groups did not differ in their self-rated measures of the above-mentioned variables. In conclusion, the authors argue that these measures are generally insensitive to depressed mood, providing an important contribution to this literature.

Kortdurende psychologische interventies voor de eerste lijn

SamenvattingMet het zogeheten generalistisch behandelprotocol kunnen mensen met lichte tot matig ernstige psychische klachten (ongeveer twee derde van de aanmeldingen in de huidige GGZ) in de eerste lijn goed worden geholpen. In deze bijdrage volgt een beknopte beschrijving van dit protocol mede aan de hand van een casus.