Die Autoren berichten über die erste kontrollierte Psychotherapiestudie, die psychoanalytische und kognitiv-verhaltenstherapeutische Langzeitpsychotherapien mit randomisierter und präferierter Zuweisung mit­einander vergleicht. In vier Behandlungszentren wurden 554 chronisch depressive Patienten interviewt, von denen 252 in die Studie aufgenommen werden konnten. In den Selbsteinschätzungen der Patienten zeigten sich große und stabile Veränderungen. Die vollständige Remissionsrate (für BDI) lag nach einem Jahr bei 34 % und stieg auf 45 % nach drei Jahren. Analoge Ergebnisse zeigten sich in den Einschätzungen der unabhängigen, bezogen auf die (...) Therapieverfahren verblindeten Rater (QIDS). Entgegen ihrer Hypothesen fanden die Autoren aber keinen statistisch signifikanten Unterschied zwischen den Verfahren und auch keine Effektunterschiede zwischen randomisierter Therapiezuweisung und Behandlung mit der präferierten Psychotherapie. Besser als in anderen Studien sind die erzielten Remissionsraten, die zeigten, dass chronisch depressive Patienten von Langzeitpsychotherapien profitieren. (shrink)

Mindfulness-based interventions have proved effective in reducing various clinical symptoms and in improving general mental health and well-being. The investigation of the mechanisms of therapeutic change needs methods for assessment of mindfulness. Existing self-report measures have, however, been strongly criticized on various grounds, including distortion of the original concept, response bias, and other. We propose a psychophysiological method for the assessment of the mindfulness learned through time-limited mindfulness-based therapy by people who undergo meditation training for the first time. We use (...) the individual pre-post-therapy changes (dERPi) in the event-related brain potentials (ERPs) recorded in a passive meditation task as a measure of increased mindfulness. dERPi is computed through multivariate assessment of individual participant's ERPs. We tested the proposed method in a group of about 70 recurrently depressed participants, randomly assigned in 1.7:1 ratio to mindfulness-based cognitive therapy (MBCT) or cognitive therapy (CT). The therapy outcome was measured by the long-term change (dDS) relative to baseline in the depression symptoms (DS) assessed weekly, for 60 weeks, by an online self-report questionnaire. We found a strong, highly significant, negative correlation (r = -0.55) between dERPi (mean = 0.4) and dDS (mean = -0.7) in the MBCT group. Compared to this result, the relationship between dDS and the other (self-report) measures of mindfulness we used was substantially weaker and not significant. So was also the relationship between dERPi and dDS in the CT group. The interpretation of dERPi as a measure of increased mindfulness was further supported by positive correlations between dERPi and the other measures of mindfulness. In this study, we also replicated a previous result, namely, the increase (dLCNV) of the late contingent negative variation (LCNV) of the ERP in the MBCT group, but not in the control group (in this case, CT). We interpreted dLCNV as a measure of increased meditative concentration. The relationship between dLCNV and dDS was, however, very week, which suggests that concentration might be relatively unimportant for the therapeutic effect of mindfulness. The proposed psychophysiological method could become an important component of a "mindfulness test battery" together with self-report questionnaires and other newly developed instruments. (shrink)