Predictores del cambio clínicamente significativo en una intervención de prevención de la depresión

  1. Vanessa Blanco Seoane
  2. Patricia Otero
  3. Lara López
  4. Ángela Torres
  5. Fernando Lino Vázquez González
Journal:
Revista iberoamericana de psicología y salud

ISSN: 2171-2069

Year of publication: 2017

Volume: 8

Issue: 1

Pages: 9-20

Type: Article

DOI: 10.23923/J.RIPS.2017.08.002 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Revista iberoamericana de psicología y salud

Sustainable development goals

Abstract

Clinically significant predictors of change in an intervention for the prevention of depression. One of the limitations of research in indicated prevention of depression is that few works have analyzed the clinical significance of the effects of the interventions. In this study, 170 non-professional caregivers with depressive symptoms were randomized to a cognitive-behavioral intervention group (n = 88) or to a usual-care control group (n = 82). The intervention was implemented in five weekly 90-minute sessions in groups of approximately five participants by trained psychologists. At postreatment, there was a significantly higher percentage of caregivers who achieved a clinically significant change in the intervention group compared to the control group (62.5% vs. 15.9%; x 2 (1, N = 170) = 38.48, p < .001). This was maintained until 12-month follow-up, when 81.8% of the intervention group obtained a clinically significant change compared to 17.1% in the control group (x 2 (1, N = 170) = 71.18, p < .001). The variables that predicted clinical change for the intervention group at postreatment were to be devoted to domestic work and older age of the care recipient. No predictors were found for the 12-month follow-up.

Bibliographic References

  • Centeno, C. (2013). Gestión del duelo y las pérdidas. Aprendiendo a convivir con lo ausente. Jaén: Formación Alcalá
  • Colombo, F., Llena-Nozal., A., Mercier, J. y Tjadens, F. (2011). Help Wanted? Providing and Paying for Long-term Care. París: OECD Publishing, OECD Health Policy Studies.
  • Cuijpers, P., Smit, F. y Willemse, G. (2005). Predicting the onset of major depression in subjects with subthreshold depression in primary care: A prospective study. Acta Psychiatrica Scandinavica, 111, 133-138. h t t p : / / d x . d o i . o r g / 1 0 . 1 1 1 1 / j . 1 6 0 0 0447.2004.00416.x
  • Dobkin, R. D., Rubino, J. T., Allen, L. A., Friedman, J., Gara, M. A., Mark, M. H. y Menza, M. (2012). Predictors of treatment response to cognitive-behavioral therapy for depression in Parkinson’s disease. Journal of Consulting and Clinical Psychology, 80, 694-699. http://dx.doi.org/10.1037/a0027695
  • Evans, C. (1998). Reliable Change Criterion Calculation. Recuperado de http://www.psyctc.org/ stats/rcsc1.htm
  • Evans, C., Margison, F. y Barkham, M. (1998). The contribution of reliable and clinically significant change methods to evidence-based mental health. Evidence-Based Mental Health, 1, 70–72. http://dx.doi.org/10.1136/ebmh.1.3.70
  • First, M. B., Spitzer, R. L., Gibbon, M. y Williams, J. B. W. (1999). Entrevista Clínica Estructurada para los Trastornos del Eje I del DSMIVVersión Clínica (SCID-CV). Barcelona: Masson. (Original publicado en 1997).
  • Gabilondo, A., Rojas-Farreras, S., Vilagut, G., Haro, J. M., Fernández, A., Pinto-Meza, A. y Alonso, J. (2010). Epidemiology of major depressive episode in a southern European country: Results from the ESEMeDSpain project. Journal of Affective Disorders 120, 76–85. http://dx.doi.org/10.1016/j.jad.2009.04.016
  • Godoy-Izquierdo, D., Godoy, J. F., LópezTorrecillas, F. y Sánchez-Barrera, M. B. (2002). Propiedades psicométricas de la versión española del “Cuestionario de salud general de Goldberg-28”. Revista de Psicología de la Salud, 14, 49-71.
  • Goldberg, D. P. y Hillier, V. F. (1979). A scaled version of the General Health Questionnaire. Psychological Medicine, 9, 139-145. http://dx.doi.org/10.1017/s0033291700021644
  • Grady, D., Cummings, S. R. y Hulley, S. B. (2008). Otros diseños de ensayos clínicos y temas de implementación. En S. B. Hulley, S. M. Cummings, W. S. Browner, D. G. Grady y T. B. Newman (Eds.), Diseño de investigaciones clínicas (pp. 185-206, 3ª Ed.). Barcelona: Lippincott Williams & Wilkins. (Original publicado en 2007).
  • Guillemin, F., Bombardier, C. y Beaton, D. (1993). Cross-cultural adaptation of health-related quality of life measures: Literature review and proposed guidelines. Journal of Clinical Epidemiology, 46, 1417-1432. http://dx.doi.org/10.1016/0895-4356(93)90142-N
  • Honaker, J., King, G. y Blackwell, M. (2009). Amelia II: A program for missing data. Recuperado de http://gking.harvard.edu/amelia
  • Institute of Medicine (1994). Reducing risks for mental disorders: Frontiers for preventive intervention research. Washington, DC: National Academy Press.
  • Instituto de Mayores y Servicios Sociales (Ed.). (2005). Cuidados a las personas mayores en los hogares españoles. El entorno familiar. Madrid: Ministerio de Trabajo y Asuntos Sociales. Recuperado de http://gking.harvard.edu/amelia
  • Jacobson, N. S., Follete, W. C. y Revenstorf, D. (1984). Psychotherapy outcome research: Methods of reporting variability and evaluation clinical significance. Behavior Therapy, 15, 336-352. http://dx.doi.org/10.1016/S0005-7894(84)80002-7
  • Jacobson, N. S. y Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59, 12-19.
  • Kazdin, A. E. (1999). The meanings and measurement of clinical significance. Journal of Consulting and Clinical Psychology, 67, 332-339. http://dx.doi.org/10.1037/0022-006X.67.3.332
  • Konnert, C., Dobson, K. y Stelmach, L. (2009). The prevention of depression in nursing home residents: A randomized clinical trial of cognitive-behavioral therapy. Aging & Mental Health, 13, 288-299. http://dx.doi.org/10.1080/13607860802380672
  • Kraemer, H. C., Wilson, G. T., Fairburn, C. G. y Agras W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59, 877–883. http://dx.doi.org/10.1001/archpsyc.59.10.877
  • Lewinsohn, P. M., Hoberman, H., Teri, L. y Hautzinger, M. (1985). An integrative theory of depression. In S. Reiss y R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 331-359). New York: Academic Press.
  • Liu, E. T. H., Chen, W. L., Li, Y. H., Wang, C. H., Mok, T. J. y Huang, H. S. (2009). Exploring the efficacy of cognitive bibliotherapy and a potential mechanism of change in the treatment of depressive symptoms among the Chinese: A randomized controlled trial. Cognitive Therapy and Research, 33, 449-461.http:// dx.doi.org/10.1007/s10608-008-9228-4
  • Lobo, A., Perez-Echeverría, M. J. y Artal, J. (1986). Validity of the scaled version of the General Health Questionnaire (GHQ-28) in a Spanish population. Psychological Medicine, 16, 135-140. http://dx.doi.org/10.1017/s0033291700002579
  • Otero, P., Smit, F., Cuijpers, P., Torres, A., Blanco, V. y Vázquez, F. L. (2015). Long-term efficacy of indicated prevention of depression in nonprofessional caregivers: Randomized controlled trial. Psychological Medicine, 45, 1401-1412. http://dx.doi.org/10.1017/s0033291714002505
  • Otero, P., Vázquez, F. L., Hermida, E., Díaz, O. y Torres, A. (2015). Relationship of cognitive behavioral therapy effects and homework in an indicated prevention of depression intervention for non-professional caregivers. Psychological Reports, 116, 841-854. http://dx.doi.org/10.2466/02.PR0.116k22w7
  • Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401. http://dx.doi.org/10.1177/014662167700100306
  • Scharlach, A. E., Sobel, E. L. y Roberts, R. E. L. (1991). Employment and caregiver strain: An integrative model. Gerontologist, 31, 778-787. http://dx.doi.org/10.1093/geront/31.6.778
  • Spek, V., Nyklíček, I., Cuijpers, P. y Pop, V. (2008). Predictors of outcome of group and internetbased cognitive behavior therapy. Journal of Affective Disorders, 105, 137-145. http://dx.doi.org/10.1016/j.jad.2007.05.001
  • Stice, E., Rohde, P., Seeley, J. R. y Gau, J. M. (2008). Brief cognitive-behavioral depression prevention program for high-risk adolescents outperforms two alternative interventions: A randomized efficacy trial. Journal of Consulting and Clinical Psychology, 76, 595-606. http://dx.doi.org/10.1037/a0012645
  • Stice, E., Rohde, P., Gau, J. M. y Wade, E. (2010). Efficacy trial of a brief cognitive-behavioral depression prevention program for high-risk adolescents: Effects at 1and 2-year follow-up. Journal of Consulting and Clinical Psychology, 78, 856-867. http://dx.doi.org/10.1037/a0020544
  • Torres, Á., Blanco, V., Vázquez, F. L., Díaz, O., Otero, P. y Hermida, E. (2015). Prevalence of major depressive episodes in non-professional caregivers. Psychiatry Research, 226, 333-339. http://dx.doi.org/10.1016/j.psychres.2014.12.066
  • Vázquez, F. L., Blanco, V. y López, M. (2007). An adaptation of the Center for Epidemiologic Studies Depression Scale for use in non-psychiatric Spanish populations. Psychiatry Research, 149, 247-252. http://dx.doi.org/10.1016/j.psychres.2006.03.004
  • Vázquez, F. L., Blanco, V., Torres, A., Otero, P. y Hermida, E. (2014). La eficacia de la prevención indicada de la depresión: una revisión. Anales de Psicología, 30, 9-24. http://dx.doi.org/10.6018/analesps.30.1.138931
  • Vázquez, F. L., Hermida, E., Torres, A., Otero, P., Blanco, V. y Díaz, O. (2014). Eficacia de una intervención preventiva cognitivo-conductual en cuidadoras con síntomas depresivos elevados. Behavioral Psychology/Psicología Conductual, 22, 79-96.
  • Vázquez, F. L., Otero, P., Torres, A., Hermida, E., Blanco, V. y Díaz, O. (2013). A brief problem-solving indicated-prevention intervention for prevention of depression in nonprofessional caregivers. Psicothema, 25, 87-92. http://dx.doi.org/10.7334/psicothema2012.89
  • Vázquez, F. L., Torres, A., Blanco, V., Díaz, O., Otero, P. y Hermida, E. (2012). Comparison of relaxation training with a cognitive-behavioural intervention for indicated prevention of depression in university students: A randomized controlled trial. Journal of Psychiatric Research, 46, 1456-1463. http://dx.doi.org/10.1016/j.jpsychires.2012.08.007
  • Vázquez, F. L., Torres, A., Blanco, V., Otero, P., Díaz, O. y Ferraces, M. J. (2016). Long-term followup of a randomized clinical trial assessing the efficacy of a brief cognitive-behavioral depression prevention intervention for caregivers with elevated depressive symptoms. American Journal of Geriatric Psychiatry. Advance online. http://dx.doi.org/10.1016/j.jagp.2016.02.050
  • Wang P. S. y Kessler R.C. (2006). Global burden of mood disorders. En D. J. Stein, D. J. Kupfer, y A. F. Schatzberg (Eds.), The American psychiatric publishing textbook of mood disorders (pp. 55-68). Washington, DC: American Psychiatric Publishing, Inc.
  • Zarit, S. H. y Femia, E. E. (2008). A future for family care and dementia intervention research? Challenges and strategies. Aging & Mental Health, 12, 5–13. http://dx.doi.org/10.1080/13607860701616317
  • Zarit, S. H., Reever, K. E. y Bach-Peterson, J. (1980). Relatives of the impaired elderly: Correlates of feelings of burden. Gerontologist, 20, 649-655. http://dx.doi.org/10.1093/geront/20.6.649