Depression treatment ‘should target emotional control’

Being able to regulate emotions is a key driver of patients' improvement in symptoms when undergoing treatment for depression, German researchers have shown.

Their discovery suggests that targeting emotional regulation could be an effective strategy for improving treatment outcomes in patients with depression.

For the study, Winfried Rief (Philipps-University of Marburg, Germany) and co-workers assessed 124 inpatients on admission to psychiatric hospitals and again on discharge.

At each assessment, patients had five skills (problem solving, social competence, stress management, relaxation ability, and emotion regulation) and two self-concepts (self-efficacy and self-esteem) measured.

As expected, the severity of depressive symptoms improved over the course of the inpatient stay. Mean scores on the Beck Depression Inventory fell from 24.85 on admission to 12.51 on discharge, indicating a significant treatment effect.

Rief's team looked for baseline factors that influenced treatment efficacy. They found that the severity of depression on admission explained 13% of the variation in severity on discharge, while the various skills and self-concepts explained a further 25%.

The latter finding was driven by the influence of emotion regulation, which emerged as the only significant predictor for outcomes among the various skills assessed. Specifically, a high ability to regulate emotions at baseline predicted a larger reduction in depressive symptoms at discharge.

Further analysis revealed that skill levels in general improved during the course of the inpatient stay, and that emotion regulation at admission influenced the association between improvements in skills and the reduction of depressive symptoms.

The researchers note that the positive impact of emotion regulation identified in this study refers only to depressive symptomatology as an outcome measure, and that other skills could be relevant with regard to other outcomes.

Nevertheless they conclude: "Based on these findings, future work should focus on developing a comprehensive theoretical model of skills as transdiagnostically relevant factors. Thus, new pathways could open up for optimizing depression treatments using emotion regulation trainings at different stages of the disorder."

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