Anthroposophic therapy for chronic depression: a four-year prospective cohort study

BACKGROUND: Depressive disorders are common, cause considerable disability, and do not always respond to standard therapy (psychotherapy, antidepressants). Anthroposophic treatment for depression differs from ordinary treatment in the use of artistic and physical therapies and special medication. We studied clinical outcomes of anthroposophic therapy for depression. METHODS: 97 outpatients from 42 medical practices in Germany participated in a prospective cohort study. Patients were aged 20–69 years and were referred to anthroposophic therapies (art, eurythmy movement exercises, or rhythmical massage) or started physician-provided anthroposophic therapy (counselling, medication) for depression: depressed mood, at least two of six further depressive symptoms, minimum duration six months, Center for Epidemiological Studies Depression Scale, German version (CES-D, range 0–60 points) of at least 24 points. Outcomes were CES-D (primary outcome) and SF-36 after 3, 6, 12, 18, 24, and 48 months. Data were collected from July 1998 to March 2005. RESULTS: Median number of art/eurythmy/massage sessions was 14 (interquartile range 12–22), median therapy duration was 137 (91–212) days. All outcomes improved significantly between baseline and all subsequent follow-ups. Improvements from baseline to 12 months were: CES-D from mean (standard deviation) 34.77 (8.21) to 19.55 (13.12) (p < 0.001), SF-36 Mental Component Summary from 26.11 (7.98) to 39.15 (12.08) (p < 0.001), and SF-36 Physical Component Summary from 43.78 (9.46) to 48.79 (9.00) (p < 0.001). All these improvements were maintained until last follow-up. At 12-month follow-up and later, 52%–56% of evaluable patients (35%–42% of all patients) were improved by at least 50% of baseline CES-D scores. CES-D improved similarly in patients not using antidepressants or psychotherapy during the first six study months (55% of patients). CONCLUSION: In outpatients with chronic depression, anthroposophic therapies were followed by long-term clinical improvement. Although the pre-post design of the present study does not allow for conclusions about comparative effectiveness, study findings suggest that the anthroposophic approach, with its recourse to non-verbal and artistic exercising therapies can be useful for patients motivated for such therapies

Die Relation der Verhaltenstherapie zu systemischer Therapie und Synergetik

Fragt man Therapeutinnen und Therapeuten, was das Gemeinsame bzw. Trennende zwischen systemischer Therapie (im Weiteren: ST), Synergetik und Verhaltenstherapie (im Weiteren: VT) ist, bekommt man annähernd so viele Antworten, wie Therapeuten befragt werden. Das lässt sich auf den individuell unterschiedlichen Ausbildungsstand, auf persönliche Arbeitsstile, konkrete therapeutische Erfahrungen, heterogene Darstellungen in der einschlägigen Literatur zurückführen. Die folgende Abhandlung des Themas muss aus den gleichen Gründen subjektiv bleiben, auch wenn durch zahlreiche Bezüge auf die Literatur eine >>objektive<< Verankerung angestrebt wird. Die Frage wird zuweilen von Patienten und Ausbildungskandidaten gestellt - also sollte man auch versuchen, eine Antwort zu finden

Wiley GAAP 2008 : Interpretation and Application of Generally Accepted Accounting Principles

New Jerseylxviii, 1276 p.; 24 cm