Efficacy of hypnotherapy compared to cognitive behavioral therapy for mild to moderate depression – results of a randomized controlled trial

Evidence for the efficacy of Hypnotherapy (HT) in the treatment of psychophysiological disorders has been previously shown. However, RCTs in regard to the treatment of psychological disorders are missing. We therefore compared the efficacy of HT with Cognitive Behavioral Therapy (CBT) in mild to moderate Major Depression (MD). We expected HT not to be inferior to CBT in the percentage reduction of depressive symptoms assessed via clinician rating after six months of individual psychotherapy. Furthermore, we assessed follow-ups regarding depressive symptoms and status of MD six and twelve months after the end of the treatment, as well as several cognitive and behavioral variables before and after treatment together with the assessment of hypnotic susceptibility.Method:The present monocentric parallel-group randomized-controlled rater-blind (non-inferiority) clinical trial included a total of 152 participants with mild to moderate MD. The patients were randomized to 20 sessions psychotherapy within six months either with CBT (n=78) or HT (n=74). Beside the systematic assessment and documentation of adverse events (AEs) and serious adverse events (SAEs), an external database and external risk-adapted monitoring of the data quality were additionally applied according to the Good Clinical Practice Guideline (GCP). Depressive symptoms were assessed with the Montgomery-Asberg Depression Rating Scale (MADRS) before and after treatment as well as six and twelve months later. Time to remission was calculated based on the weekly status of MD with the Longitudinal Interval Follow-up Evaluation DSM-IV (LIFE).Results:The mean percentage improvement in the MADRS score was about 38% in the CPP sample after the end of treatment (n = 134). We found that HT was not inferior to CBT in the mean percentage reduction of depressive symptoms (p = .622, d = .08). Similar results were found in the ITT sample.At baseline, both groups did not differ regarding age, sex, and depressive symptoms, medication status or treatment preferences as well as in the other variables (hypnotic susceptibility, self-efficacy, behavioral activation, quality of life and rumination). Furthermore, the treatment groups did not differ in the number and type of reported (S)AEs. Further results concerning follow-ups, time to remission and potential predictors for treatment response will be presented in the conference.Conclusion:This is the first RCT to show that HTevidences results comparable to CBT in MD, when applying rigorous methodological standards.(Funded by the Milton Erickson Society Germany.)

کلیدواژه ها:

Hypnotherapy ، Major Depression ، Cognitive Behavioral Therapy ، Efficacy ، RCT