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Erschienen in: Der Nervenarzt 3/2006

01.03.2006 | Weiterbildung · Zertifizierte Fortbildung

Spezifische Therapie für chronische Depression

Das „Cognitive Behavioral Analysis System of Psychotherapy“ nach McCullough

verfasst von: Dr. E. Schramm, F. Caspar, M. Berger

Erschienen in: Der Nervenarzt | Ausgabe 3/2006

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Zusammenfassung

Chronische Depressionen sind häufige Störungen, die ausgeprägtes Leiden und enorme Kosten verursachen. Traditionelle pharmakologische und psychotherapeutische Behandlungsansätze zeigten bisher nur mäßigen Erfolg. Bei dem „Cognitive Behavioral Analysis System of Psychotherapy“ (CBASP) von James McCullough handelt es sich um ein spezifisch auf chronische Depression zugeschnittenes Verfahren, bei dem behaviorale, kognitive und interpersonelle Strategien integriert werden. Der Ansatz ist empirisch überprüft und hat sich als wirksam erwiesen. Der vorliegende Beitrag erläutert den derzeitigen Forschungsstand bei der psychotherapeutischen Behandlung chronischer Depression. Neben der Herleitung des Ansatzes werden die wichtigsten therapeutischen Strategien und Techniken des CBASP beschrieben.
Fußnoten
1
„komplementär“ hier im Sinne der Interpersonalen Modelle, nicht wie unten sensu Caspar und Grawe.
 
Literatur
1.
Zurück zum Zitat Arnow BA, Constantino MJ (2003) Effectiveness of psychotherapy and combination treatment for chronic depression. J Clin Psychol 59: 893–905CrossRefPubMed Arnow BA, Constantino MJ (2003) Effectiveness of psychotherapy and combination treatment for chronic depression. J Clin Psychol 59: 893–905CrossRefPubMed
2.
Zurück zum Zitat Barrett JE, Williams JW Jr, Oxman TE et al. (2001) Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years. J Fam Pract 50: 405–412PubMed Barrett JE, Williams JW Jr, Oxman TE et al. (2001) Treatment of dysthymia and minor depression in primary care: a randomized trial in patients aged 18 to 59 years. J Fam Pract 50: 405–412PubMed
3.
Zurück zum Zitat Beck AT, Rush AJ, Shaw BF et al. (1979) Cognitive therapy of depression. Guilford Press, New York Beck AT, Rush AJ, Shaw BF et al. (1979) Cognitive therapy of depression. Guilford Press, New York
4.
Zurück zum Zitat Browne G, Steiner M, Roberts J et al. (2002) Sertraline and/or interpersonal psychotherapy for patients with dysthymic disorder in primary care: 6-month comparison with longitudinal 2-year follow-up of effectiveness and costs. J Affect Disord 68: 317–330CrossRefPubMed Browne G, Steiner M, Roberts J et al. (2002) Sertraline and/or interpersonal psychotherapy for patients with dysthymic disorder in primary care: 6-month comparison with longitudinal 2-year follow-up of effectiveness and costs. J Affect Disord 68: 317–330CrossRefPubMed
5.
Zurück zum Zitat Caspar F (1996) Beziehungen und Probleme verstehen. Eine Einführung in die psychotherapeutische Plananalyse. Huber, Bern Caspar F (1996) Beziehungen und Probleme verstehen. Eine Einführung in die psychotherapeutische Plananalyse. Huber, Bern
6.
Zurück zum Zitat Caspar F (2002) Das Impact Message Inventory von Kiesler. In: Brähler E, Schumacher J, Strauss B (Hrsg) Diagnostische Verfahren in der Psychotherapie. Beltz, Weinheim, S 214–216 Caspar F (2002) Das Impact Message Inventory von Kiesler. In: Brähler E, Schumacher J, Strauss B (Hrsg) Diagnostische Verfahren in der Psychotherapie. Beltz, Weinheim, S 214–216
7.
Zurück zum Zitat Caspar F, Grossmann C, Unmüssig C et al. (2005) Complementary therapeutic relationship: therapist behavior, interpersonal patterns, and therapeutic effects. Psychother Res 15: 91–102CrossRef Caspar F, Grossmann C, Unmüssig C et al. (2005) Complementary therapeutic relationship: therapist behavior, interpersonal patterns, and therapeutic effects. Psychother Res 15: 91–102CrossRef
8.
Zurück zum Zitat de Jong R, Treiber R, Henrich G (1986) Effectiveness of two psychological treatments for inpatients with severe and chronic depression. Cognitive Ther Res 10: 645–663CrossRef de Jong R, Treiber R, Henrich G (1986) Effectiveness of two psychological treatments for inpatients with severe and chronic depression. Cognitive Ther Res 10: 645–663CrossRef
9.
Zurück zum Zitat Dunner DL (2001) Acute and maintenance treatment of chronic depression. J Clin Psychiatry 62 [Suppl 6]: 10–16 Dunner DL (2001) Acute and maintenance treatment of chronic depression. J Clin Psychiatry 62 [Suppl 6]: 10–16
10.
Zurück zum Zitat Dunner DL, Schmaling KB, Hendrickson H et al. (1996) Cognitive therapy versus fluoxetine in the treatment of dysthymic disorder. Depression 4: 34–41CrossRefPubMed Dunner DL, Schmaling KB, Hendrickson H et al. (1996) Cognitive therapy versus fluoxetine in the treatment of dysthymic disorder. Depression 4: 34–41CrossRefPubMed
11.
Zurück zum Zitat Friedman MA, Detweiler-Bedell JB, Leventhal HE (2004) Combined psychotherapy and pharmacotherapy for the treatment of Major Depressive Disorder. Clin Psychol Sci Pract 11: 47–68CrossRef Friedman MA, Detweiler-Bedell JB, Leventhal HE (2004) Combined psychotherapy and pharmacotherapy for the treatment of Major Depressive Disorder. Clin Psychol Sci Pract 11: 47–68CrossRef
12.
Zurück zum Zitat Gelenberg AJ, Trivedi MH, Rush AJ et al. (2003) Randomized, placebo-controlled trial of nefazodone maintenance treatment in preventing recurrence in chronic depression. Biol Psychiatry 54: 806–817CrossRefPubMed Gelenberg AJ, Trivedi MH, Rush AJ et al. (2003) Randomized, placebo-controlled trial of nefazodone maintenance treatment in preventing recurrence in chronic depression. Biol Psychiatry 54: 806–817CrossRefPubMed
13.
Zurück zum Zitat Gordon DE (1988) Formal operations and interpersonal and affective disturbances in adolescents. In: Nannis ED, Cowan PA (eds) Developmental psychopathology and its treatment. Jossey-Bass, San Francisco, pp 51–73 Gordon DE (1988) Formal operations and interpersonal and affective disturbances in adolescents. In: Nannis ED, Cowan PA (eds) Developmental psychopathology and its treatment. Jossey-Bass, San Francisco, pp 51–73
14.
Zurück zum Zitat Grawe K (1992) Komplementäre Beziehungsgestaltung als Mittel zur Herstellung einer guten Therapiebeziehung. In: Margraf J, Brengelmann J (Hrsg) Die Therapeut-Patient-Beziehung in der Verhaltenstherapie. Gerhard Röttger, München, S 215–244 Grawe K (1992) Komplementäre Beziehungsgestaltung als Mittel zur Herstellung einer guten Therapiebeziehung. In: Margraf J, Brengelmann J (Hrsg) Die Therapeut-Patient-Beziehung in der Verhaltenstherapie. Gerhard Röttger, München, S 215–244
15.
Zurück zum Zitat Hegerl U, Plattner A, Moller HJ (2004) Should combined pharmaco- and psychotherapy be offered to depressed patients? A qualitative review of randomized clinical trials from the 1990s. Eur Arch Psychiatry Clin Neurosci 254: 99–107CrossRefPubMed Hegerl U, Plattner A, Moller HJ (2004) Should combined pharmaco- and psychotherapy be offered to depressed patients? A qualitative review of randomized clinical trials from the 1990s. Eur Arch Psychiatry Clin Neurosci 254: 99–107CrossRefPubMed
16.
Zurück zum Zitat Hellerstein DJ, Yanowitch P, Rosenthal J et al. (1993) A randomized double-blind study of fluoxetine versus placebo in the treatment of dysthymia. Am J Psychiatry 150: 1169–1175PubMed Hellerstein DJ, Yanowitch P, Rosenthal J et al. (1993) A randomized double-blind study of fluoxetine versus placebo in the treatment of dysthymia. Am J Psychiatry 150: 1169–1175PubMed
17.
Zurück zum Zitat Hirschfeld RM, Dunner DL, Keitner G et al. (2002) Does psychosocial functioning improve independent of depressive symptoms? A comparison of nefazodone, psychotherapy, and their combination. Biol Psychiatry 51: 123–133CrossRefPubMed Hirschfeld RM, Dunner DL, Keitner G et al. (2002) Does psychosocial functioning improve independent of depressive symptoms? A comparison of nefazodone, psychotherapy, and their combination. Biol Psychiatry 51: 123–133CrossRefPubMed
18.
Zurück zum Zitat Keller MB, McCullough JP, Klein DN et al. (2000) A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. N Engl J Med 342: 1462–1470CrossRefPubMed Keller MB, McCullough JP, Klein DN et al. (2000) A comparison of nefazodone, the cognitive behavioral-analysis system of psychotherapy, and their combination for the treatment of chronic depression. N Engl J Med 342: 1462–1470CrossRefPubMed
19.
Zurück zum Zitat Kessler RC, McGonagle KA, Zhao S et al. (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 51: 8–19PubMed Kessler RC, McGonagle KA, Zhao S et al. (1994) Lifetime and 12-month prevalence of DSM-III-R psychiatric disorders in the United States. Results from the National Comorbidity Survey. Arch Gen Psychiatry 51: 8–19PubMed
20.
Zurück zum Zitat Kiesler DJ (1996) Contemporary interpersonal theory and research: personality, psychopathology, and psychotherapy. Wiley, New York Kiesler DJ (1996) Contemporary interpersonal theory and research: personality, psychopathology, and psychotherapy. Wiley, New York
21.
Zurück zum Zitat Klein DN, Santiago NJ, Vivian D et al. (2004) Cognitive-behavioral analysis system of psychotherapy as a maintenance treatment for chronic depression. J Consult Clin Psychol 72: 681–688CrossRefPubMed Klein DN, Santiago NJ, Vivian D et al. (2004) Cognitive-behavioral analysis system of psychotherapy as a maintenance treatment for chronic depression. J Consult Clin Psychol 72: 681–688CrossRefPubMed
22.
Zurück zum Zitat Klein DN, Schatzberg AF, McCullough JP et al. (1999) Early- versus late-onset dythymic disorder: comparison in out-patients with superimposed major depressive episodes. J Affect Disord 52: 187–196CrossRefPubMed Klein DN, Schatzberg AF, McCullough JP et al. (1999) Early- versus late-onset dythymic disorder: comparison in out-patients with superimposed major depressive episodes. J Affect Disord 52: 187–196CrossRefPubMed
23.
Zurück zum Zitat Klerman GL, Weissman M, Rounsaville BJ et al. (1984) Interpersonal psychotherapy of depression. Basic Books, New York Klerman GL, Weissman M, Rounsaville BJ et al. (1984) Interpersonal psychotherapy of depression. Basic Books, New York
24.
25.
Zurück zum Zitat Manber R, Arnow B, Blasey C et al. (2003) Patient’s therapeutic skill acquisition and response to psychotherapy, alone or in combination with medication. Psychol Med 33: 693–702CrossRefPubMed Manber R, Arnow B, Blasey C et al. (2003) Patient’s therapeutic skill acquisition and response to psychotherapy, alone or in combination with medication. Psychol Med 33: 693–702CrossRefPubMed
26.
Zurück zum Zitat Markowitz JC (1994) Psychotherapy of dysthymia. Am J Psychiatry 151: 1114–1121PubMed Markowitz JC (1994) Psychotherapy of dysthymia. Am J Psychiatry 151: 1114–1121PubMed
27.
Zurück zum Zitat Makowitz IC, Kocsis IH, Bleiberg KL, Christos PJ, Sacks M (2005) A comparative trial of psychotherapy and pharmacotherapy for „prue“ dysthymic patients. J Affect Disord 89: 167–175CrossRefPubMed Makowitz IC, Kocsis IH, Bleiberg KL, Christos PJ, Sacks M (2005) A comparative trial of psychotherapy and pharmacotherapy for „prue“ dysthymic patients. J Affect Disord 89: 167–175CrossRefPubMed
28.
Zurück zum Zitat McCullough JP (2000) Treatment for chronic depression. Cognitive behavioral analysis system of psychotherapy. Guilford Press, New York McCullough JP (2000) Treatment for chronic depression. Cognitive behavioral analysis system of psychotherapy. Guilford Press, New York
29.
Zurück zum Zitat McCullough JP (2001) Skills training manual for diagnosing and treating chronic depression: Cognitive Behavioral Analysis System of Psychotherapy. Guilford Press, New York McCullough JP (2001) Skills training manual for diagnosing and treating chronic depression: Cognitive Behavioral Analysis System of Psychotherapy. Guilford Press, New York
30.
Zurück zum Zitat McCullough JP (2003) Treatment for chronic depression using Cognitive Behavioral Analysis System of Psychotherapy (CBASP). J Clin Psychol 59: 833–846CrossRefPubMed McCullough JP (2003) Treatment for chronic depression using Cognitive Behavioral Analysis System of Psychotherapy (CBASP). J Clin Psychol 59: 833–846CrossRefPubMed
31.
Zurück zum Zitat Miller IW, Norman WH, Keitner GI (1999) Combined treatment for patients with double depression. Psychother Psychosom 68: 180–185CrossRefPubMed Miller IW, Norman WH, Keitner GI (1999) Combined treatment for patients with double depression. Psychother Psychosom 68: 180–185CrossRefPubMed
32.
Zurück zum Zitat Nemeroff CB, Heim CM, Thase ME et al. (2003) Differential responses to psychotherapy versus pharmacotherapy in patients with chronic forms of major depression and childhood trauma. Proc Natl Acad Sci USA 100: 14293–14296CrossRefPubMed Nemeroff CB, Heim CM, Thase ME et al. (2003) Differential responses to psychotherapy versus pharmacotherapy in patients with chronic forms of major depression and childhood trauma. Proc Natl Acad Sci USA 100: 14293–14296CrossRefPubMed
33.
Zurück zum Zitat Piaget J (1926) The language and thought of the child. Harcourt Brace, New York Piaget J (1926) The language and thought of the child. Harcourt Brace, New York
34.
Zurück zum Zitat Piaget J (1981) Intelligence and affectivity: their relationship during child development. Annual Reviews, Palo Alto Piaget J (1981) Intelligence and affectivity: their relationship during child development. Annual Reviews, Palo Alto
35.
Zurück zum Zitat Ravindran AV, Anisman H, Merali Z et al. (1999) Treatment of primary dysthymia with group cognitive therapy and pharmacotherapy: clinical symptoms and functional impairments. Am J Psychiatry 156: 1608–1617PubMed Ravindran AV, Anisman H, Merali Z et al. (1999) Treatment of primary dysthymia with group cognitive therapy and pharmacotherapy: clinical symptoms and functional impairments. Am J Psychiatry 156: 1608–1617PubMed
36.
Zurück zum Zitat Schatzberg AF, Rush AJ, Arnow BA et al. (2005) Chronic depression: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not. Arch Gen Psychiatry 62: 513–520CrossRefPubMed Schatzberg AF, Rush AJ, Arnow BA et al. (2005) Chronic depression: medication (nefazodone) or psychotherapy (CBASP) is effective when the other is not. Arch Gen Psychiatry 62: 513–520CrossRefPubMed
37.
Zurück zum Zitat Schramm E (1998) Interpersonelle Psychotherapie, 2. Aufl. Schattauer, Stuttgart Schramm E (1998) Interpersonelle Psychotherapie, 2. Aufl. Schattauer, Stuttgart
38.
Zurück zum Zitat Schramm E, Schweiger U, Hohagen F et al. (2006) Dt. Übersetzung und Bearbeitung von: McCullough JP (2000) Treatment for chronic depression. Cognitive Behavioral Analysis System of Psychotherapy. Elsevier, München (im Druck) Schramm E, Schweiger U, Hohagen F et al. (2006) Dt. Übersetzung und Bearbeitung von: McCullough JP (2000) Treatment for chronic depression. Cognitive Behavioral Analysis System of Psychotherapy. Elsevier, München (im Druck)
39.
Zurück zum Zitat Skinner BF (1953) Science and human behavior. Macmillan, New York Skinner BF (1953) Science and human behavior. Macmillan, New York
40.
Zurück zum Zitat Sullivan M (1953) The interpersonal theory of psychiatry. Norton Press, New York Sullivan M (1953) The interpersonal theory of psychiatry. Norton Press, New York
41.
Zurück zum Zitat Williams JW Jr, Barrett J, Oxman T et al. (2000) Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. JAMA 284: 1519–1526CrossRefPubMed Williams JW Jr, Barrett J, Oxman T et al. (2000) Treatment of dysthymia and minor depression in primary care: a randomized controlled trial in older adults. JAMA 284: 1519–1526CrossRefPubMed
Metadaten
Titel
Spezifische Therapie für chronische Depression
Das „Cognitive Behavioral Analysis System of Psychotherapy“ nach McCullough
verfasst von
Dr. E. Schramm
F. Caspar
M. Berger
Publikationsdatum
01.03.2006
Erschienen in
Der Nervenarzt / Ausgabe 3/2006
Print ISSN: 0028-2804
Elektronische ISSN: 1433-0407
DOI
https://doi.org/10.1007/s00115-006-2059-1

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