Objective Psychotherapies for depression are similarly effective, but the processes through which these therapies work have not been identified. We focus on psychological process changes during therapy as predictors of long-term depression outcome in treatment responders. Method: Secondary analysis of a randomized trial comparing cognitive therapy (CT) and interpersonal psychotherapy (IPT) that focuses on 85 treatment responders. Using mixed-effects models, changes during therapy (0-7 months) on nine process variables were associated with depression severity (BDI-II) at follow-up (7-24 months). Results: A decrease in dysfunctional attitudes was associated with a decrease in depression scores over time. Improved self-esteem was associated with less depression at follow-up (borderline significant). More improvement in both work and social functioning and interpersonal problems was associated with better depression outcomes in IPT relative to CT, while less improvement in work and social functioning and interpersonal problems was associated with better outcomes in CT relative to IPT. Conclusions: Less negative thinking during therapy is associated with lower depression severity in time, while changes during therapy in work and social functioning and interpersonal problems appear to predict different long-term outcomes in CT vs. IPT. If replicated, these findings can be used to guide clinical decision-making during psychotherapy.

中文翻译：

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心理治疗期间的心理过程变化是否可以预测成功的认知治疗或人际心理治疗后的长期抑郁症结果？一项随机试验的二次分析。

客观 抑郁症的心理疗法同样有效，但尚未确定这些疗法起作用的过程。我们关注治疗期间的心理过程变化，作为治疗反应者长期抑郁结果的预测指标。方法：对一项比较认知疗法 (CT) 和人际心理疗法 (IPT) 的随机试验进行二次分析，该试验重点关注 85 名治疗反应者。使用混合效应模型，治疗期间（0-7 个月）九个过程变量的变化与随访（7-24 个月）时的抑郁严重程度 (BDI-II) 相关。结果：随着时间的推移，功能失调态度的减少与抑郁评分的降低有关。自尊心的提高与随访时抑郁程度的降低有关（临界显着）。工作和社会功能以及人际关系问题的更多改善与 IPT 相对于 CT 的抑郁结果更好相关，而工作和社会功能以及人际关系问题的改善较少与 CT 相对于 IPT 的更好结果相关。结论：治疗期间较少的消极想法与较低的抑郁严重程度及时相关，而治疗期间工作和社会功能以及人际关系问题的变化似乎可以预测 CT 与 IPT 的不同长期结果。如果重复，这些发现可用于指导心理治疗期间的临床决策。而工作和社会功能以及人际关系问题的较少改善与 CT 相对于 IPT 的更好结果相关。结论：治疗期间较少的消极想法与较低的抑郁严重程度及时相关，而治疗期间工作和社会功能以及人际关系问题的变化似乎可以预测 CT 与 IPT 的不同长期结果。如果重复，这些发现可用于指导心理治疗期间的临床决策。而工作和社会功能以及人际关系问题的较少改善与 CT 相对于 IPT 的更好结果相关。结论：治疗期间较少的消极想法与较低的抑郁严重程度及时相关，而治疗期间工作和社会功能以及人际关系问题的变化似乎可以预测 CT 与 IPT 的不同长期结果。如果重复，这些发现可用于指导心理治疗期间的临床决策。