depression

Background: Depression is one of the most prevalent psychiatric disorders that imposes a heavy economic, emotional and social burden on patients, families and society.
Objectives: The present study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and cognitive therapy (CT) in treating Iranian women patients with major depressive disorder (MDD).
Methods: Nineteen women outpatients meeting DSM-IV-TR criteria for MDD without any axis 2 disorders were randomly (goal-oriented and convenience sampling) assigned to one of two treatment conditions, i.e. ACT and CT. The intervention in acceptance and commitment therapy group that was conducted was based on the Zeattle manual for major depressive disorder. Twelve therapeutic sessions were administered in the consulting center of Tehran university twice a week. The control group received 12 sessions of cognitive therapy based on Ferry manual twice a week in the consulting center of Tehran university, too. The Beck depression inventory-II-second edition (BDI-II), acceptance and act questionnaire (AAQ-II) and dysfunctional attitude scale (DAS) were administered for pre-treatment, post-treatment and follow-up. The data was analyzed by repeated measures analysis of variance (ANOVA).
Results: ANCOVA results showed that there were significant differences between ACT and CT in dysfunctional attitude. The ACT group demonstrated significant improvement in acceptance in the pre-test and post-test stage. All the participants demonstrated significant improvement in depression.
Conclusions: As ACT improved depression and acceptance of internal experiences, it is recommended for depression as an effective psychotherapy.

Introduction: The purpose of this study was to evaluate the effectiveness of acceptance and commitment therapy on reducing anxiety, depression and post-traumatic stress disorder in women affected by spousal extramarital relationships.
Methods: This is a quasi-experimental study with a pretest-posttest design with control group. The statistical population of the study consisted of all couples affected by extramarital affairs who referred to Birjand Welfare Counseling Center in the second half of 1997. Of these, 30 subjects who met the inclusion criteria were selected through available sampling and randomly assigned to either experimental (n = 15) and control (n = 15) groups. Intervention method was based on commitment and acceptance therapy with 8 sessions of training to the experimental group and the control group received no treatment. Data were collected using the Kian et al. Traumatic Stress Questionnaire (3) and the Lovebond and Lovebond Depression Anxiety Inventory (21). Data analysis was performed using covariance
analysis.
Results: The results of the present study showed an increase in the mean scores of the variables of anxiety, depression and post-traumatic stress in the experimental group at post-test compared to the intervention group (P <0.01).
Conclusion: The results of this study indicate that acceptance and commitment therapy is effective in reducing anxiety, depression and post-traumatic stress disorder in women affected by spouse trans marital relations.
 

خالصه
مقدمه:پژوهش حاضر با هدف اثربخشي درمان مبتني بر پذيرش و تعهد بر کاهش اضطراب،
افسردگي واسترس پس از سانحه زنان آسیبديده از روابط فرا زناشويي همسر انجام شد.
روش کار:پژوهش نیمه آزمايشي با طرح پیشآزمون–پسآزمون با گروهکنترل است. جامعه
آماری پژوهش را کلیه زوجین آسیبديده از روابط فرا زناشويي که در ششماهه دوم سال79به
مرکز مشاوره بهزيستي شهر بیرجند مراجعه کردند، تشكیل داد. از اينبین تعداد30نفر که شرايط
ورود به پژوهش را داشتند، به شیوه در دسترس انتخاب و به طور تصادفيبه دو گروه آزمايش (65
نفر) و کنترل (65نفر) منتسب شدند. روش اجرای مداخلهی درمان مبتني بر تعهد و پذيرش بهصورت
آموزش در8جلسه به گروه آزمايش بود و گروه گواه هیچ درماني دريافت نكردند. برای گردآوری
دادهها از پرسشنامهاسترس پس از سانحهکیان و همكاران (3)و پرسشنامه افسردگي، اضطراب
الويبوند و الويبوند (26) استفاده شد. تجزيهوتحلیل دادهها با کمک تحلیل کوواريانس انجام شد.
نتایج:نتايج مطالعه حاضر، افزايش میانگین نمرات در متغیرهای اضطراب، افسردگي واسترس پس از
سانحه را در گروه آزمايش در مرحله پسآزمون نسبت بهگروه مداخله نما نشان داد (06/0>p.)
نتیجه گیری:نتايج پژوهش بیانگر آن است که درمان مبتني بر پذيرش و تعهد بر کاهش اضطراب،
افسردگي واسترس پس از سانحه زنان آسیبديده از روابط فرا زناشويي همسر مؤثر است.
کلمات کلیدی:درمان مبتني بر پذيرش و تعهد، اضطراب، افسردگي، استرس پس از سانحه، روابط
 

A prior open trial of acceptance and commitment therapy (ACT) for comorbid social anxiety disorder (SAD) and depression showed clinically significant improvement over the course of 16 sessions. The aim of the current study was to test the feasibility and acceptability of ACT for this population in a pilot randomized trial within a routine practice setting. Patients (n = 26) were randomly assigned to 16 weeks of medication treatment as usual (mTAU) versus mTAU plus ACT (mTAU + ACT). Results showed that a significantly greater percentage of patients in mTAU not only dropped out of the study but also dropped out of treatment at the practice altogether, compared to patients in mTAU + ACT. Overall, results from this study suggest that having a comparison condition of mTAU alone in a randomized trial in a routine practice setting is not feasible and that patients with comorbid forms of SAD may require psychotherapy to remain engaged in treatment in standard clinical practice. Preliminary results for patients within the mTAU + ACT condition on treatment satisfaction and outcomes were comparable to results from the prior open trial, suggesting that ACT itself is worthy of further investigation. Further modifications to the study design may be needed to develop a feasible and acceptable comparison condition against which to test ACT for comorbid SAD in a routine practice setting.

A pilot parallel randomized controlled trial compared a self-acceptance, non-weight-loss intervention, Accept Yourself! (AY), to a weight loss program, Weight Watchers (WW), in order to provide preliminary safety, feasibility, and efficacy data in preparation for a definitive RCT of AY as an intervention to enhance the mental and physical health of larger-bodied women with Major Depressive Disorder (MDD). Adult women with MDD and a Body Mass Index ≥30 were eligible. Nineteen women were randomized by random number table into AY (n = 9) or WW (n = 10). Intake, pretreatment, posttreatment, 3-, 6-, 9-, and 12-month follow-up assessments occurred at a rural academic medical center. Primary outcomes included depression severity and cardiovascular fitness. Chi-square and t-tests assessed attrition and participant preferences for treatment; other analyses used intention-to-treat, linear mixed-effects models for repeated measures, including all participants' available data. Both groups improved in self-reported, F(5, 43.81) = 7.45, p < .001, partial η² = .38, and blinded-clinician-rated depression, F(6, 62.03) = 10.41, p < .001, partial η² = .5. AY was superior to WW in self-reported depression, F(5, 43.81) = 2.72, p = .03, partial η² = .11. Neither group improved in fitness. Eating disorder symptoms and weight gain worsened in WW. AY appeared safe, feasible, and offered initial evidence of efficacy for depression; it should be investigated in a definitive RCT, with modifications to increase potency. WW may not be suitable as a comparator intervention for AY because of risk to participants.