2026-06-01T02:31:36Zhttps://docta.ucm.es/rest/oai/request

oai:docta.ucm.es:20.500.14352/1337122026-03-04T00:56:19Zcom_20.500.14352_14col_20.500.14352_15

Long-term depressive symptoms trajectories following CBT delivered in primary care compared to usual treatment Prieto Vila, Maider González Blanch, César Saunders, Rob Buckman, Joshua E. J. Muñoz Navarro, Roger Esteller Collado, Gabriel Barrio Martínez, Sara Moriana, Juan A. Ruiz Rodríguez, Paloma Carpallo González, María Cano Vindel, Antonio Rafael Depression Growth mixture modeling Primary care Prognostic factors Treatment trajectories Psicología (Psicología) Psicología clínica y psicodiagnóstico 61 Psicología 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). Background The 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). Methods Growth 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). Results We 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. Conclusions There 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. Ministerio de Ciencia e Innovación Depto. de Psicología Experimental, Procesos Cognitivos y Logopedia Fac. de Psicología TRUE pub 2026-03-03T09:34:09Z 2026-03-03T09:34:09Z 2024-12 journal article VoR https://hdl.handle.net/20.500.14352/133712 0033-2917 10.1017/s0033291724002976 1469-8978 eng 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 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ open access application/pdf Cambridge University Press