Geschlechtsunterschiede in der multimodalen Therapie depressiver Störungen mit komorbider Schmerzsymptomatik

Zusammenfassung

Anliegen: Die vorliegende Studie analysierte den Einfluss des Geschlechts auf das Ergebnis einer multimodalen psychosomatischen Behandlung depressiver Patienteninnen und Patienten mit komorbider Schmerzstörung.

Methode: 154 Patientinnen und 144 Patienten durchliefen ein 5-wöchiges standardisiertes Therapieprogramm. Die depressive Symptomatik wurde anhand der Allgemeinen Depressionsskala vor und nach der Behandlung erfasst.

Ergebnisse: Die depressive Symptomatik verbessert sich bei Frauen (ES 0,96) mehr als bei Männern (ES 0,65), sowohl in der Gesamtstichprobe (t = 2,757; p = 0,006), als auch in der Teilstichprobe ohne antidepressive Medikation (t = 2,325; p = 0,021).

Schlussfolgerung: Frauen mit Depressionen und Schmerzen profitieren mehr von einer multimodalen Behandlung als Männer.

Abstract

Objective: Although gender differences are increasingly the focus of current research, gender aspects in the response to pharmacological and non-pharmacological treatment of depression still remain unclear. The aim of this study was to analyze the impact of gender on the outcome of a CBT-orientated multimodal treatment in depressed outpatients with chronic pain.

Methods: A total of 298 patients (154 women) underwent a standardized five-week CBT-orientated multimodal treatment. Depressive symptoms were measured at the beginning and end of the treatment with the German version of the Center for Epidemiological Studies Depression Scale (CES-D).

Results: The improvement of depressive symptoms showed an effect size (ES) of 0.81 in the total sample. However, women improved considerably more (ES 0.96) than did men (ES 0.65) and these gender differences are seen in the complete sample (t = 2.757, df = 296, p = 0.006) as well as in the group without received antidepressants (t = 2.325, df = 151, p = 0.021).

Conclusion: Women with a depressive disorder and chronic pain benefit significantly more from a CBT-orientated multimodal treatment and exhibit a considerably greater reduction of depressive symptoms than do men. These distinctions are not due to differences in received antidepressant medication, psychiatric comorbidities or educational background.

Schlüsselwörter

geschlechtsspezifische Unterschiede - depressive Störung - Psychotherapie - chronische Schmerzen

Keywords

gender differences - depression - cognitive-behavioral therapy - chronic pain

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