Treating An Affective Disorder

Question 1

What was the aim in Reisinger?

Answer 1

Find out whether a behavioural therapy, token economy, could be used to treat an inpatient with a diagnosis of depression

Question 2

What was the method in Reisinger?

Answer 2

Case study

Question 3

Who were the pps in Reisinger?

Answer 3

A white female, 20 years old, been an inpatient for 6 years

Question 4

What was the procedure in Reisinger?

Answer 4

Informed could gain or lose tokens. They could be traded in for TV, better sleeping, trips ect.
Received one when observed smiling. Also got social reinforcement, ‘well done’
Fine when crying. Record kept.
Lasted 20 weeks, other various complex introduced

Question 5

What were the measurements taken in Reisinger?

Answer 5

Smiling response: slight open mouth, up turn lips
Crying: tears for 5-30 mins
Response recorded by staff 3x a day, rating 2 hours max, arranged in conjunction with meals.
Observers at least 10 ft away
Inter-rater reliability, 95 coefficient across ratings

Question 6

What were the results in Reisinger?

Answer 6

Baseline, smiling was 0 a week, crying 30.
Final week of treatment, 27 smiling, 2 crying.
14 months later, patient had no recommendations for hospitalisation or further treatment.

Question 7

What was the conclusion in Reisinger?

Answer 7

Behavioural therapies can be very effective in treating depression

Question 8

What was the aim in Karp and Frank?

Answer 8

Compare drug treatment and non-drug treatments for depression

Question 9

What was the method in Karp and Frank?

Answer 9

Review article

Question 9

Who were the pps in Karp and Frank?

Answer 9

Research reviewed was concentrated on women diagnosed with depression.
9 pieces of research.
From 1974-1992
529 took part in selected studies.

Question 10

What was the design in Karp and Frank?

Answer 10

Depression analysed using variety of depression inventories. All patients tested prior to treatment.
Tested after treatment using inventories, some cases a period of time after as a follow up.
Practitioners sometimes used to assess patients

Question 11

What were the results in Karp and Frank?

Answer 11

Most studies- adding psychological treatments to drug therapy did not increase effectiveness.
People more likely to continue treatment if cognitive in addition to drug therapy

Question 12

What was the conclusion in Karp and Frank?

Answer 12

The evidence shows that two treatments doesn’t show any better outcomes for patients offered combined therapy, oppose to only drug therapy.

Question 13

What was the aim in Riggs?

Answer 13

Evaluate the effect of fluoxetine vs placebo in combination with combined behavioural therapy (CBT) on depression, substance abuse disorders and conduct disorders.

Question 14

What was the method in Riggs?

Answer 14

Independent measures, randomised controlled study. CBT was directed at substance abuse rather than depression

Question 15

Who were the pps in Riggs?

Answer 15

126 U18s, with diagnosed depression

Also had diagnosed conduct disorder and substance abuse disorder.

Question 16

What was the procedure in Riggs?

Answer 16

Pps spent 16 weeks being treated either:
. Fluoxetine and a corse of CBT directed at dealing with substance abuse.
. Placebo and a corse of CBT directed at substance abuse

Question 17

What were the results in Riggs?

Answer 17

Combined of CBT and fluoxetine may be the most effective option as it led to significant improvements on one measure of depression in combo with CBT and placebo

Question 18

What conclusions are there in Riggs?

Answer 18

Combined approach is better, results significantly more due to drugs in the body and CBT to mind and behaviour.