Comparison of behavioral activation therapy and treatment as usual among depressed patients in secondary psychiatric care

Introduction Evidence-based brief therapies are needed to reduce a marked heterogeneity affecting treatment of depression within the public psychiatric care. They should be easy to implement and use for a large group of patients. Objectives To develop and implement an effective brief treatment protocol for depressed patients treated in public psychiatric secondary care. Aim To explore and compare the outcome of depressed patients receiving either behavioral activation therapy (BA) or treatment as usual (TAU). Methods Two hundred and forty two depressive patients referred to adult public secondary psychiatric care formed the BA treated study group. The TAU treated control group ( n  = 205) was collected from the hospital districts database and matched by the hospitalization rate, Alcohol Use Disorders Identification Test (AUDIT) and Beck Depression Inventory (BDI). All patients received anti-depressive medications. In the study group, Montgomery–Asberg Depression Rating Scale (MADRS) was conducted four times within 24 months follow-up. In both groups, the ability of functioning was controlled by Global Assessment of Functioning scale (GAF). Results In the study group, depressive symptoms alleviated systematically and significantly during follow-up ( Table 1 ). The improvement in GAF scores was significantly better in the study group throughout the follow-up ( Table 1 ). Conclusions BA can be implemented and used effectively for depressive patients in public psychiatric secondary care. BA is superior to TAU in terms of functional recovery.