The authors have no potential conflicts of interest to disclose.
Author Contributions
Conceptualization: Onur Yılmaz, Ali Barlas Mırçık, Merve Kunduz, Müge Çombaş, Ahmet Öztürk, Erdem Deveci, İsmet Kırpınar. Data curation: Onur Yılmaz, Ali Barlas Mırçık, Merve Kunduz, Müge Çombaş. Formal Analysis: Onur Yılmaz, Ali Barlas Mırçık, Merve Kunduz, Müge Çombaş, Ahmet Öztürk, Erdem Deveci. Investigation: Onur Yılmaz, Ali Barlas Mırçık, Merve Kunduz, Müge Çombaş. Methodology: Onur Yılmaz, Ali Barlas Mırçık, Merve Kunduz, Müge Çombaş, Ahmet Öztürk, Erdem Deveci, İsmet Kırpınar. Project administration: Onur Yılmaz. Resources: Onur Yılmaz, Ahmet Öztürk, Erdem Deveci. Software: Onur Yılmaz, Ahmet Öztürk, Erdem Deveci. Validation: Onur Yılmaz, Ahmet Öztürk, Erdem Deveci, İsmet Kırpınar. Writing—Original draft: Onur Yılmaz, Ahmet Öztürk, Erdem Deveci. Writing—Review & editing: Onur Yılmaz, Ahmet Öztürk, Erdem Deveci, İsmet Kırpınar.
Number of patients who left the study are presented alongside the reasons in parantheses. ExP: existential psychotherapy, CBT: cognitive behavioral therapy, SUP: supportive counselling, N: number of patients, St: number before sessions started, W: weekly sessions, B: booster sessions, dns: did not start, dnc: did not continue, sbm: sent back to clinics for possible medication, lc: left the city because of a jobwechsel, dncb: did not continue for boosters
Session number | Content of session in brief |
---|---|
W1 | Noting current complaints, getting brief knowledge about patient’s history of disorder, pharmacotherapy and psychotherapy (if any), showing some cognitive contradictions, setting appropriate and available targets, proposing treatment rationale for the agenda. |
W2 | Discussing available cognitive contradictions and showing some more, mentioning the term “automatic thoughts” and deriving them from existing contradictions, demonstrating possible initiating, triggering and maintaininig factors, setting homework(s). |
W3 | Evaluation of homework(s) exploring more automatic thoughts and evaluating alternative thoughts against them, elaborating triggering and maintaining factors setting new homework(s). |
W4 | Evaluation of homework(s) testing certain automatic thoughts and elaborating more, evaluating alternative thoughts, retracing triggering and maintaining factors setting new homework(s). |
W5 | Evaluation of homework(s), testing and evaluating more (new, if explored any) automatic thoughts, elaborating and retracing initiating factors, mentioning the term “intermediary beliefs” and deriving some of them from outcomes until then, setting new homework(s). |
W6 | Evaluation of homework(s), elaborating and testing intermediary beliefs evaluating original and current targets setting new homework(s). |
W7 | Evaluation of homework(s), testing more (new, if explored any) intermediary beliefs retracing initiating factors, setting new homework(s). |
W8 | Evaluation of homework(s), overall assessment of alternative automatic thoughts and intermediary beliefs, overall assessment of original and current targets, setting new (monthly) homework(s). |
B1 | Evaluation of homework(s), overall assessment of alternative automatic thoughts and intermediary beliefs *mentioning the term “core beliefs” and deriving some from intermediary beliefs (if needed), overall assessment of original and current targets, setting new (monthly) homework(s). |
B2 | Overall assessment of alternative automatic thoughts and intermediary beliefs (and core beliefs if needed), overall assessment of original and current targets, evaluating how to use new skills in case of relapse and recurrence. |
Kruskal-Wallis was used for comparison of numerical data and chi-square test was used for comparison of categorical variables. Ages of groups are expressed as mean±standard deviation. Other values are expressed as percentiles. N: number of subjects, p: probability value, ExP: existential psychotherapy group, CBT: cognitive behavioral therapy group, SUP: supportive counselling group
Time of measurement | ExP (N=20) | CBT (N=21) | SUP (N=20) | p |
---|---|---|---|---|
Bgn | 30.98 | 29.12 | 33.00 | 0.781 |
Awk | 20.90 | 27.62 | 44.65 | <0.01 |
ABst | 23.30 | 24.52 | 45.50 | 0.021 |
Kruskal-Wallis was used for comparison of numerical data. Significant differences are demonstrated with bold characters. HDRS: Hamilton Depression Rating Scale, N: number of subjects, p: probability value, ExP: existential psychotherapy group, CBT: cognitive behavioral therapy group, SUP: supportive counselling group, Bgn: mean rank for HDRS scores before the start of sessions, Awk: mean rank for HDRS scores after weekly sessions, Abst: mean rank for HDRS scores after booster sessions
Mann-Whitney U was used for comparison of numerical data. Significant differences are demonstrated with bold characters. HDRS: Hamilton Depression Rating Scale, P: probability value, ExP: existential psychotherapy group, CBT: cognitive behavioral therapy group, SUP: supportive counselling group, vs: versus, Bgn: mean values before the start of sessions, Awk: mean values after weekly sessions, Abst: mean values after booster sessions, m: mean rank
Wilcoxon Signed Rank Test was used for comparison of numerical data. HDRS scores are expressed as mean±standard deviation. Significant differences are demonstrated with bold characters. HDRS: Hamilton Depression Rating Scale, N: number of subjects, p: probability value, ExP: existential psychotherapy group, CBT: cognitive behavioral therapy group, SUP: supportive counselling group, vs: versus, Bgn: mean values before the start of sessions, Awk: mean values after weekly sessions, Abst: mean values after booster sessions
Kruskal-Wallis was used for comparison of numerical data. Significant differences are demonstrated with bold characters. N: number of subjects, p: probability value, ExP: existential psychotherapy group, CBT: cognitive behavioral therapy group, SUP: supportive counselling group, Bgn: mean ranks before sessions start, Awk: mean ranks after weekly sessions, Abst: mean ranks after booster sessions
Mann-Whitney U was used for comparison of numerical data. Significant differences are demonstrated with bold characters. P: probability value, m: mean rank, ExP: existential psychotherapy group, CBT: cognitive behavioral therapy group, SUP: supportive counselling group, vs: versus, Awk: mean values after weekly sessions, Abst: mean values after booster sessions
Comparison |
ExP |
CBT |
SUP |
|||
---|---|---|---|---|---|---|
Mean | p | Mean | P | Mean | p | |
Bgn vs. ABst | ||||||
Happy | (6.0±0.9) vs. (6.7±0.6) | <0.01 | (5.8±1.2) vs. (6.5±0.8) | 0.020 | (6.2±0.8) vs. (6.4±1.0) | 0.166 |
Sad | (6.0±1.0) vs. (6.4±0.6) | 0.046 | (6.2±1.0) vs. (6.3±1.0) | 0.605 | (5.8±1.2) vs. (5.3±1.6) | 0.216 |
Fearful | (5.1±1.5) vs. (5.7±1.1) | 0.025 | (5.5±1.4) vs. (5.6±1.3) | 0.773 | (5.0±1.3) vs. (5.3±1.4) | 0.245 |
Disgusted | (4.7±1.5) vs. (5.5±1.2) | <0.01 | (4.6±1.7) vs. (4.4±1.5) | 0.406 | (4.5±1.5) vs. (4.6±1.4) | 0.954 |
Angry | (6.3±1.1) vs. (6.5±0.7) | 0.463 | (5.9±1.1) vs. (6.1±0.9) | 0.392 | (5.9±1.1) vs. (5.5±1.1) | 0.179 |
Surprised | (4.0±1.5) vs. (5.6±0.9) | <0.01 | (4.2±1.4) vs. (4.8±1.5) | 0.124 | (4.1±1.7) vs. (4.5±1.3) | 0.237 |
Neutral | (3.8±1.5) vs. (5.6±0.9) | <0.01 | (4.2±1.6) vs. (4.7±1.2) | 0.222 | (4.1±1.4) vs. (4.0±1.4) | 0.660 |
Bgn vs. Awk | ||||||
Happy | (6.0±0.9) vs. (6.6±0.6) | <0.01 | (5.8±1.2) vs. (6.4±0.8) | 0.031 | (6.2±0.8) vs. (6.3±1.0) | 0.564 |
Sad | (6.0±1.0) vs. (6.3±0.7) | 0.218 | (6.2±1.0) vs. (6.3±0.8) | 0.485 | (5.8±1.2) vs. (4.9±1.2) | 0.022* |
Fearful | (5.1±1.5) vs. (5.7±1.2) | 0.032 | (5.5±1.4) vs. (5.4±1.2) | 0.724 | (5.0±1.3) vs. (5.1±1.3) | 0.600 |
Disgusted | (4.7±1.5) vs. (5.2±1.2) | 0.88 | (4.6±1.7) vs. (4.2±1.4) | 0.221 | (4.5±1.5) vs. (4.4±1.5) | 0.623 |
Angry | (6.3±1.1) vs. (6.4±0.7) | 0.744 | (5.9±1.1) vs. (5.9±0.8) | 0.971 | (5.9±1.1) vs. (5.1±1.2) | 0.038* |
Surprised | (4.0±1.5) vs. (6.4±0.6) | <0.01 | (4.2±1.4) vs. (4.6±1.5) | 0.308 | (4.1±1.7) vs. (4.3±1.3) | 0.440 |
Neutral | (3.8±1.5) vs. (5.3±1.0) | <0.01 | (4.2±1.6) vs. (4.8±1.3) | 0.155 | (4.1±1.4) vs. (3.9±1.4) | 0.383 |
Awk vs. ABst | ||||||
Happy | (6.6±0.6) vs. (6.7±0.6) | 0.317 | (6.4±0.8) vs. (6.5±0.8) | 0.564 | (6.3±1.0) vs. (6.4±1.0) | 0.083 |
Sad | (6.3±0.7) vs. (6.4±0.6) | 0.083 | (6.3±0.8) vs. (6.3±1.0) | 0.564 | (4.9±1.2) vs. (5.3±1.6) | 0.059 |
Fearful | (5.7±1.2) vs. (5.7±1.1) | 0.317 | (5.4±1.2) vs. (5.6±1.3) | 0.102 | (5.1±1.3) vs. (5.3±1.4) | 0.102 |
Disgusted | (5.2±1.2) vs. (5.5±1.2) | 0.034 | (4.2±1.4) vs. (4.4±1.5) | 0.083 | (4.4±1.5) vs. (4.6±1.4) | 0.157 |
Angry | (6.4±0.7) vs. (6.5±0.7) | 0.157 | (5.9±0.8) vs. (6.1±0.9) | 0.102 | (5.1±1.2) vs. (5.5±1.1) | 0.109 |
Surprised | (6.4±0.6) vs. (5.6±0.9) | 0.157 | (4.6±1.5) vs. (4.8±1.5) | 0.157 | (4.3±1.3) vs. (4.5±1.3) | 0.157 |
Neutral | (5.3±1.0) vs. (5.6±0.9) | 0.066 | (4.8±1.3) vs. (4.7±1.2) | 0.317 | (3.9±1.4) vs. (4.0±1.4) | 0.492 |