Longitudinal Clusters of Long-Term Trajectories in Patients with Early-Onset Chronic Depression: 2 Years of Naturalistic Follow-Up after Extensive Psychological Treatment

• DOI: 10.1159/000535005
• Publication Date: 2023-12-28T22:00:25Z
• Authors: Moritz Elsaesser; Bernd Feige; Levente Kriston; Lea Schumacher; Jasmin Peifer; Martin Hautzinger; Martin Härter; Elisabeth Schramm
• Keywords: Depression; Chronic depression; Longitudinal Study

<b><i>Introduction:</i></b> In clinical trials, mostly group-level treatment effects of repeated cross-sectional measures are analyzed. However, substantial heterogeneity regarding individual symptom profiles and the variability often neglected, especially over long-term course. To provide effective personalized treatments, investigations these characteristics urgently needed. <b><i>Methods:</i></b> Depression severity ratings 104 weeks follow-up after year-long with Cognitive Behavioral Analysis System Psychotherapy (CBASP) or Supportive (SP) were Longitudinal cluster analysis multinomial logistic regression conducted to investigate intraindividual trajectories from one largest psychotherapy trials in early-onset chronic depression. <b><i>Results:</i></b> Two-year post-study-treatment <i>N</i> = 188 patients depression grouped into four prototypical clusters. Overall, 16.0% remitted (cluster 1) most them did not receive any during 2-year follow-up. 84.0% continued experience subthreshold (37.2% 2) major depressive symptoms (46.8% clusters 3–4) spent on average more than half pharmacological psychological treatment. Hierarchical indicated that previous study CBASP SP significantly predict allocation, while baseline variables accounted for a large proportion explained variance (<i>R</i><sup>2</sup> <sub>N</sub> 0.64). <b><i>Conclusion:</i></b> While some experienced stable remission 2 years follow-up, majority regardless former SP. This calls perspective implementing staging innovative approaches such as sequential model modular psychotherapy.