Evaluation of the Effectiveness of Cognitive Behavioural Therapy for Patients Suffering From an Adjustment Disorder

Abstract

Dominique Jonkers*, Peter ten Klooster, Maarten K. van Dijk, Colin van der Heiden and Marc J. P. M. Verbraak

Aim: To investigate the effectiveness of a higher initial dose of sessions in 12 weeks of individual CBT (Cognitive Behavioural Therapy) regarding speeded recovery in patients with an adjustment disorder.

Methods: A pre-post intervention trial conducted among 50 adults treated for AD as the primary diagnosis between November 2011 and December 2012. Patients were randomized to a regular treatment condition (one session each week) or an initial intensive treatment condition (two sessions per week over the first four weeks, one session every two weeks thereafter) to investigate a possible dose-response relationship. The primary outcome measure was psychosocial symptoms (OQ-45). Secondary outcome measures were resumption of work and quality of life (RAND-36). Analyses were performed in 2021-2022.

Results: A significant and large reduction in psychosocial symptoms was found across the two conditions over time (B=-4.0; p<0.001; 95% CI=-5.2 to -2.8; d=1.5). Furthermore, resumption of work (B=0.05; p<0.001) and all aspects of health-related quality of life significantly improved as treatment progressed. Although condition by time interactions were not significant for any of the outcome measures, the intensive treatment condition did show a trend towards a more rapid reduction of psychosocial symptoms in the first four weeks of treatment (between-group d=0.6).

Conclusions: CBT was associated with a large reduction in psychosocial symptoms and improvements in resumption of work and health-related quality of life in AD. Results further suggest a more rapid reduction of symptoms when treatment is delivered in a higher frequency.