The influence of depressive symptoms on the efficacy of a short-term group form of Schema Cognitive Behavioural Therapy for personality disorders: A naturalistic study

Abstract Background: This naturalistic study looked at the effect of comorbid depressive symptoms on the outcomes – at treatment termination and three-month follow-up – of Short-Term Schema Cognitive Behavioural Therapy in groups for personality disorders. Methods: We investigated 225 patients with personality disorders and comorbid depressive symptoms (PD-DEP) and patients without comorbidity (PD), focusing on symptom and schema severity and coping styles. We also measured the rate of symptom remission. The data obtained were subjected to multilevel analysis. Results: Psychiatric symptoms and maladaptive schemas improved in both patient groups. Effect sizes were moderate. It proved more difficult to improve coping styles. Symptom remission was achieved in the minority of the total sample There were no differences in outcome between PD and PD-DEP at treatment termination. Psychiatric symptoms were more severe among PD-DEP patients at follow-up. Conclusion: A short-term form of schema therapy in groups proved to be an effective approach for a broad group of patients with personality disorders, however, the majority of patients did not achieve symptom remission. This indicates that this type of short-term group therapy should be considered a valuable first step in a stepped-care model.