Long-term effects of a cognitive-behavioral training program for the management of depressive symptoms among patients in orthopedic inpatient rehabilitation of chronic low back pain: a 2-year follow-up

The aim of the present study was to investigate the 2-year outcome of a cognitive-behavioral training program for the management of depressive symptoms for patients with chronic low back pain (CLBP) and co-existing depressive symptoms compared with the standard rehabilitation. Therefore, a quasi-experimental 3 × 2 × 5 (treatment condition × gender × time) repeated measures design with five assessment points (pre-treatment, post-treatment, 6-, 12-, and 24-month follow-up) was employed among N = 153 patients with CLBP, aged 33–62 years. Patients were consecutively assigned to one of three treatment conditions: patients with no or mild depressive symptoms were treated with the standard rehabilitation (CG) and patients with moderate or severe depressive symptoms were either treated with the standard rehabilitation (CG_depr) or the standard rehabilitation plus cognitive-behavioral management of depressive symptoms (IG_depr). Patients in the IG_depr significantly improved in mental health up to the 6-month follow-up and in anxiety and depressive symptoms up to the 24-month follow-up. Only short- or mid-term improvements were found in the CG_depr. In conclusion, the new cognitive-behavioral training program augmented the long-term rehabilitation success in this highly strained subgroup of patients with CLBP and depressive symptoms.