RT Journal Article
T1 Long-term depressive symptoms trajectories following CBT delivered in primary care compared to usual treatment
A1 Prieto Vila, Maider
A1 González Blanch, César
A1 Saunders, Rob
A1 Buckman, Joshua E. J.
A1 Muñoz Navarro, Roger
A1 Esteller Collado, Gabriel
A1 Barrio Martínez, Sara
A1 Moriana, Juan A.
A1 Ruiz Rodríguez, Paloma
A1 Carpallo González, María
A1 Cano Vindel, Antonio Rafael
AB BackgroundThe course of depression is heterogeneous. The employed treatment is a key element in the impact of the course of depression over the time. However, there is currently a gap of knowledge about the trajectories per treatment and related baseline factors. We aimed to identify trajectories of depressive symptoms and associated baseline characteristics for two treatment arms in a randomized clinical trial: treatment as usual (TAU) or TAU plus transdiagnostic group cognitive behavioral therapy (TAU + TDG-CBT).MethodsGrowth mixture modeling (GMM) was used to identify trajectories of depressive symptoms over 12 months post-treatment. Logistic regression models were used to examine associations between baseline characteristics and trajectory class membership in 483 patients (TAU: 231; TAU + TDG-CBT: 251).ResultsWe identified different patterns of symptom change in the randomized groups: two trajectories in TAU (‘improvement’ (71.4%) and ‘no improvement’ (28.6%)), and four trajectories in TAU + TDG-CBT (‘recovery’ (69.8%), ‘late recovery’ (5.95%), ‘chronicity’ (4.77%), and ‘relapse’ (19.44%)). Higher baseline symptom severity and comorbidity were associated with poorer treatment outcomes in both treatment groups and worse emotional regulation strategies were linked to the ‘no improvement trajectory’ in TAU. The TAU + TDG-CBT group demonstrated greater symptom reduction compared to TAU alone.ConclusionsThere is heterogeneity in treatment outcomes. Integration of TDG-CBT with TAU significantly improves symptom reduction compared to TAU alone. Patients with higher baseline severity and comorbidities show poorer outcomes. Identification of trajectories and related factors could assist clinicians in tailoring treatment strategies to optimize outcomes, particularly for patients with a worse prognosis.
PB Cambridge University Press
SN 0033-2917
YR 2024
FD 2024-12
LK https://hdl.handle.net/20.500.14352/133712
UL https://hdl.handle.net/20.500.14352/133712
LA eng
NO Prieto-Vila, M., González-Blanch, C., Saunders, R., Buckman, J. E. J., Muñoz-Navarro, R., Esteller Collado, G., Barrio-Martínez, S., Moriana, J. A., Ruiz-Rodríguez, P., Carpallo-González, M., & Cano-Vindel, A. (2024). Long-term depressive symptoms trajectories following CBT delivered in primary care compared to usual treatment. Psychological Medicine, 54(16), 4918-4927. https://doi.org/10.1017/S0033291724002976
NO 2025 Otros acuerdos transformativos UCM.This research was supported by the Spanish Ministry of Science (RETOS grant PID2019-107243RB-C21 and FPI grant PRE2020-092381).
NO Ministerio de Ciencia e Innovación
DS Docta Complutense
RD 21 mar 2026