Under pressure: Vulnerability and stress in recurrent depression and new technologies to prevent relapse.

Gemma Kok

Under pressure: Vulnerability and stress in recurrent depression and new technologies to prevent relapse.

Vertaalde titel van de bijdrage: Onder druk: Kwetsbaarheid en stress bij terugkerende depressie en nieuwe technologieën om terugval te voorkomen.

Gemma Kok

Experimental Psychotherapy & Psychopathology

Onderzoeksoutput: Thesis fully internal (DIV)

702 Downloads (Pure)

Samenvatting

Depressie is een veelvoorkomende aandoening, welke gepaard gaat met veel leed voor mensen zelf en hun omgeving. Voor veel mensen is een depressie geen eenmalige, maar een terugkerende aandoening. In dit proefschrift getiteld “Under pressure” zijn potentiële risicofactoren van terugval en het voorkomen van terugval onderzocht bij mensen met terugkerende depressie(s).

Potentiële risicofactoren
Bij mensen die eerdere episoden van depressie meegemaakt hebben, was alledaagse stress geassocieerd met een slechter beloop van depressie. Bovendien vonden we dat de aanwezigheid van een mogelijke persoonlijkheidsstoornis geassocieerd was met verhoogde cognitieve kwetsbaarheid (bijvoorbeeld meer rumineren). Het hebben meegemaakt van trauma’s in de kindertijd, maar ook het hebben van een chronisch somatische ziekte, bleek niet samen te hangen met een slechter beloop van depressie.

Voorkomen van terugval
Psychologische therapieën, tijdens (gedeeltelijk) herstel, lijken effectief in het verminderen van depressieve terugval, eveneens bij weinig voorgaande episoden. Preventie van terugval is daarom van belang voor iedereen die een depressie heeft meegemaakt. Ter vergroting van de toegankelijkheid van zorg, zou internet-therapie uitkomst kunnen bieden. Resultaten tonen dat, in aanvulling op reguliere zorg, een preventieve cognitieve behandeling via het internet, met minimale therapeutenondersteuning en stemmingsmonitoring (Mobiele Cognitieve Therapie), een effectieve en acceptabele manier is ter voorkoming van een toename van depressieve klachten na herstel bij mensen met meerdere voorgaande depressies.

Waarschijnlijk heeft niet iedereen dezelfde soort en vorm van behandeling nodig. Gepersonaliseerde behandeling op basis van specifieke risicofactoren voor terugval binnen een persoon, zou kunnen helpen bij het selecteren van de best mogelijke preventie van terugval behandeling.

Vertaalde titel van de bijdrage	Onder druk: Kwetsbaarheid en stress bij terugkerende depressie en nieuwe technologieën om terugval te voorkomen.
Originele taal-2	English
Kwalificatie	Doctor of Philosophy
Toekennende instantie	Rijksuniversiteit Groningen
Begeleider(s)/adviseur	Bockting, Claudi, Supervisor Smit, Filip, Supervisor, Externe Persoon Burger, Huibert, Co-supervisor
Datum van toekenning	29-sep.-2014
Plaats van publicatie	[S.l.]
Uitgever	[S.n.]
Gedrukte ISBN's	978-90-367-7130-6
Elektronische ISBN's	978-90-367-7131-3
Status	Published - 2014

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title = "Under pressure: Vulnerability and stress in recurrent depression and new technologies to prevent relapse.",

abstract = "Depression is highly prevalent disorder and is associated with a high disease burden for people themselves and their environment. To many people, depression does not occur just once in a lifetime, but is a highly recurrent condition. In this thesis, entitled 'Under pressure', we examined potential risk factors of depressive relapse and how to prevent relapse in people with recurrent depression(s). Potential risk factors For people who had experienced previous episodes of depression, daily hassles were associated with a poorer course of depression. Further, we demonstrated that the presence of a possible personality disorder was associated with increased levels of cognitive vulnerability (e.g. more rumination). Being exposed to childhood trauma and the presence of a chronic somatic illness, were not associated with a poorer depression course. Prevention of relapse Psychological therapies, offered during (partial) remission, seem effective in reducing the risk of depressive relapse, also for people with relatively few previous episodes. Prevention of relapse is therefore important to anyone who has experienced depression. To increase the accessibility of care, Internet-based therapies could be of importance. Results demonstrated that, in addition to regular treatment, an Internet-based preventive cognitive treatment with minimal therapist support and mood monitoring (Mobile Cognitive Therapy) is an effective and acceptable way of preventing an increase in depressive symptomatology after remission in recurrently depressed individuals.Possibly not everyone needs the same type and form of treatment. Personalized treatment based on specific risk factors within an individual might help in providing the best possible prevention of relapse.",

author = "Gemma Kok",

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N2 - Depression is highly prevalent disorder and is associated with a high disease burden for people themselves and their environment. To many people, depression does not occur just once in a lifetime, but is a highly recurrent condition. In this thesis, entitled 'Under pressure', we examined potential risk factors of depressive relapse and how to prevent relapse in people with recurrent depression(s). Potential risk factors For people who had experienced previous episodes of depression, daily hassles were associated with a poorer course of depression. Further, we demonstrated that the presence of a possible personality disorder was associated with increased levels of cognitive vulnerability (e.g. more rumination). Being exposed to childhood trauma and the presence of a chronic somatic illness, were not associated with a poorer depression course. Prevention of relapse Psychological therapies, offered during (partial) remission, seem effective in reducing the risk of depressive relapse, also for people with relatively few previous episodes. Prevention of relapse is therefore important to anyone who has experienced depression. To increase the accessibility of care, Internet-based therapies could be of importance. Results demonstrated that, in addition to regular treatment, an Internet-based preventive cognitive treatment with minimal therapist support and mood monitoring (Mobile Cognitive Therapy) is an effective and acceptable way of preventing an increase in depressive symptomatology after remission in recurrently depressed individuals.Possibly not everyone needs the same type and form of treatment. Personalized treatment based on specific risk factors within an individual might help in providing the best possible prevention of relapse.

AB - Depression is highly prevalent disorder and is associated with a high disease burden for people themselves and their environment. To many people, depression does not occur just once in a lifetime, but is a highly recurrent condition. In this thesis, entitled 'Under pressure', we examined potential risk factors of depressive relapse and how to prevent relapse in people with recurrent depression(s). Potential risk factors For people who had experienced previous episodes of depression, daily hassles were associated with a poorer course of depression. Further, we demonstrated that the presence of a possible personality disorder was associated with increased levels of cognitive vulnerability (e.g. more rumination). Being exposed to childhood trauma and the presence of a chronic somatic illness, were not associated with a poorer depression course. Prevention of relapse Psychological therapies, offered during (partial) remission, seem effective in reducing the risk of depressive relapse, also for people with relatively few previous episodes. Prevention of relapse is therefore important to anyone who has experienced depression. To increase the accessibility of care, Internet-based therapies could be of importance. Results demonstrated that, in addition to regular treatment, an Internet-based preventive cognitive treatment with minimal therapist support and mood monitoring (Mobile Cognitive Therapy) is an effective and acceptable way of preventing an increase in depressive symptomatology after remission in recurrently depressed individuals.Possibly not everyone needs the same type and form of treatment. Personalized treatment based on specific risk factors within an individual might help in providing the best possible prevention of relapse.

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