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About one in three patients with depression suffer from persistent depressive disorder (PDD). Since the inclusion of PDD in the Diagnostic and Statistical Manual (DSM-5), it has received increasing scientific attention. To this day, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is the only ...

About one in three patients with depression suffer from persistent depressive disorder (PDD). Since the inclusion of PDD in the Diagnostic and Statistical Manual (DSM-5), it has received increasing scientific attention. To this day, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) is the only psychotherapy model specifically developed for the treatment of PDD. International guidelines recommend it as the first line treatment for PDD.

Several clinical trials have shown the efficacy of CBASP in the treatment of chronic depression. Yet many questions remain that this Research Topic will seek to address. These questions range from basic research on PDD to clinical trials of CBASP. Submission of papers of other treatment modalities for PDD are also welcome.

The questions that will be addressed in this Research Topic include but are not limited to:

• the term “chronic depression” has not only been applied to PDD but also been applied to some patients with episodic depression and frequent episodes – are these two categories really distinct?
• the CBASP model states that chronic depression is associated with interpersonal problems that arise against the background of adverse childhood experience – is this model supported by the data?
• the efficacy of CBASP individual therapy is beyond doubt – but is it really superior to other forms of psychotherapy and is CBASP also effective in daily practice? What is known about the effectiveness in other settings, e.g. group therapy, inpatient setting and internet interventions?
• the size of the effect of CBASP in treating PDD is small to moderate – which are the subgroups of patients that benefit most? Early-onset depression? Patients who have experienced childhood maltreatment? Are adaptations necessary for these or other subgroups?
• CBASP has been specifically developed for the treatment of PDD – but is it also effective in other mental disorders including bipolar depression or patients with predominant personality disorders?
• existing data support the CBASP change theory that changes in the therapeutic relationship lead to an improvement to interpersonal functioning – but is this finding really unique to CBASP?
• numerous studies show that psychotherapy also affects neurobiology – can this be demonstrated for CBASP was well?
• treatment with CBASP does often but not always result in treatment response – what kind of maintenance treatment should be offered to treatment responders? What options exist if CBASP is not successful?

Keywords: Persistent Depressive Disorder, Psychotherapy, Interpersonal Theory, Clinical Trials, Therapeutic Relationship


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