Childhood trauma and differential response to long-term psychoanalytic versus cognitive–behavioural therapy for chronic depression in adults

• DOI: 10.1192/bjp.2024.112
• Publication Date: 2024-08-09T11:37:33Z
• Authors: Lina Krakau; Mareike Ernst; Martin Hautzinger; Manfred E. Beutel; Marianne Leuzinge...
• Keywords: CTQ tree; Depression; Moderation; Chronic depression

Background Childhood trauma is a major risk factor for chronic depression. It has been suggested that adults with depression who have experienced childhood may require long-term treatment owing to breakdown of basic trust and related difficulties in developing productive therapeutic relationship. Aims As empirical studies preliminary scarce, we studied the effects psychoanalytic therapy (PAT) versus cognitive–behavioural (CBT) history trauma. In this subgroup, expected greater symptom reduction PAT compared CBT. Method large trial psychotherapies (LAC-Study; Clinical Trial Register ISRCTN91956346), 210 received open-ended CBT or an out-patient setting were examined yearly over 5 years on Beck Depression Inventory – II (BDI-II). Based linear mixed model approach, tested participant-reported based Trauma Questionnaire (CTQ) as predictor moderator outcome. CTQ subscales exploratively. Results Depressive symptoms decreased time ( b = −4.55, s.e. 0.90, 95% CI −6.32 −2.81, T −5.08; P < 0.001). A significant three-way interaction between trauma, group −0.05, 0.02, −0.09 −0.01, −2.42; 0.016) indicated participants profited especially well from PATs. Conclusions Our results indicate differential benefits among The important implications indication policy.