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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychol. | doi: 10.3389/fpsyg.2019.01714

A Comparison of Metacognitive Therapy in Current versus Persistent Depressive Disorder – a Pilot Outpatient Study

  • 1Hannover Medical School, Germany
  • 2University of Manchester, United Kingdom
  • 3Universität zu Lübeck, Germany

Background: Metacognitive therapy (MCT) is a modern approach with demonstrated efficacy in current major depressive disorder (MDD). The treatment aims to modify thinking styles of rumination and worry and their underlying metacognitions, which have been shown to be involved in the initiation and perpetuation of MDD. We hypothesized that metacognitive therapy may also be effective in treating persistent depressive disorder (PDD).
Methods: Thirty depressed patients (15 with MDD; 15 with PDD) were included. Patients in both groups were comparable on depression severity and sociodemographic characteristics, but PDD was associated with more former treatments. Metacognitive therapy was applied by trained psychotherapists for a mean of 16 weeks.
Results: We observed a significant improvement of depressive symptoms in both groups, and comparable remission rates at the end of treatment and after 6 months follow-up. Furthermore, we observed significant and similar levels of improvement in rumination, dysfunctional metacognitions and anxiety symptoms in both groups.
Limitations: The study is limited by the small sample size and a missing independent control group. The effect of the therapeutic alliance was not controlled. The quality of depression rating could have been higher.
Conclusions: We demonstrated that metacognitive therapy can successfully be applied to patients with PDD. The observed results were comparable to those obtained for patients with current major depressive disorder. Further studies with larger groups and a randomized design are needed to confirm these promising initial findings.

Keywords: MCT, Metacognitive Therapy (MCT), Depression, Persistent depressive disorder, thinking style, metacognition, Psychotherapy, Major Depressive Disorder

Received: 28 Mar 2019; Accepted: 09 Jul 2019.

Edited by:

Ana Fonseca, Faculty of Psychology and Educational Sciences, University of Coimbra, Portugal

Reviewed by:

Sverre U. Johnson, Modum Bad Psychiatric Center, Norway
Roger Hagen, Norwegian University of Science and Technology, Norway  

Copyright: © 2019 Winter, Gottschalk, Nielsen, Wells, Schweiger and Kahl. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Lotta Winter, Hannover Medical School, Hanover, 30625, Germany,