Elisabeth Schramm

Elisabeth Schramm
University Medical Center Freiburg · Department of Psychiatry and Psychotherapy

About

263
Publications
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Introduction
Additional affiliations
October 1995 - present
University Medical Center Freiburg
Position
  • Sektionsleitung

Publications

Publications (263)
Article
Full-text available
Interpersonal psychotherapy (IPT) and antidepressant medications are both first-line interventions for adult depression, but their relative efficacy in the long term and on outcome measures other than depressive symptomatology is unknown. Individual participant data (IPD) meta-analyses can provide more precise effect estimates than conventional met...
Article
Psychotherapies are efficacious in the treatment of depression, albeit only with a moderate effect size. It is hoped that personalization of treatment can lead to better outcomes. The network theory of psychopathology offers a novel approach suggesting that symptom interactions as displayed in person‐specific symptom networks could guide treatment...
Article
Background: Child maltreatment is a broadly confirmed risk factor for mental and physical illness. Some psychological treatments specifically target mental health conditions associated with child maltreatment. For example, the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) focuses on maladaptive interpersonal behaviours in chronic de...
Article
Effect sizes of psychotherapies currently stagnate at a low‐to‐moderate level. Personalizing psychotherapy by algorithm‐based modular procedures promises improved outcomes, greater flexibility, and a better fit between research and practice. However, evidence for the feasibility and efficacy of modular‐based psychotherapy, using a personalized trea...
Article
Full-text available
Importance Physical diseases co-occur with late-life depression (LLD). The influence of physical diseases and the subjective perception of physical health (PPH) on treatment outcome in LLD, however, is not well understood. Objective To assess the association of physical diseases and PPH with the outcomes of 2 different types of psychotherapy in LL...
Article
Full-text available
Introduction: In clinical trials, mostly group-level treatment effects of repeated cross-sectional measures are analyzed. However, substantial heterogeneity regarding individual symptom profiles and the variability of treatment effects are often neglected, especially over the long-term course. To provide effective personalized treatments, investiga...
Article
Importance: Conceptualizing mental disorders as latent entities has been challenged by the network theory of mental disorders, which states that psychological problems are constituted by a network of mutually interacting symptoms. While the implications of the network approach for planning and evaluating treatments have been intensively discussed,...
Article
Full-text available
There exists little empirical evidence helping clinicians to select the most effective treatment for individual patients with persistent depressive disorder (PDD). This study identifies and characterizes subgroups of patients with PDD who are likely to benefit more from an acute treatment with psychotherapy than from pharmacotherapy and vice versa....
Preprint
Objective: To examine differential symptom-specific improvements across the therapies Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and Supportive Psychotherapy (SP) in patients with persistent depressive disorder (PDD), incorporating interpersonal problems, and social functioning as potential mediators. Method: We conducted a three...
Article
Full-text available
Introduction: Different psychotherapeutic interventions for late-life depression (LLD) have been proposed, but their evaluation in large, multicenter trials is rare. Objective: The present study evaluated the efficacy of a specific cognitive behavioral therapy (CBT) for LLD (LLD-CBT) in comparison with a supportive unspecific intervention (SUI), bo...
Preprint
Full-text available
Introduction: In randomized trials, mostly group-level treatment effects of repeated cross-sectional measures are analyzed. However, substantial heterogeneity regarding individual symptom profiles and variability of treatment effects are often neglected, particularly over the long-term course.Objective: Ratings of depression severity over 104 weeks...
Book
Full-text available
Derzeit erfahren psychotherapeutische Ansätze einen Wandel in Richtung eines individualisierten, modularen Organisationsprinzips. Dabei wird an gestörten Mechanismen und weniger an Störungsbildern oder Theorien von Therapieschulen angesetzt. Die Modulare Psychotherapie bietet ein Konzept von hoher Praktikabilität in der ambulanten und stationären V...
Article
We read with great interest Habtewold and colleagues’ (2022) update on a meta-analysis of randomized controlled trials examining the efficacy of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) in chronic depression in comparison with other treatments. We appreciate this update as the original meta-analysis by Negt et al. (2016) is...
Article
Full-text available
Background Due to budget restrictions in mental health care, non-professional caregivers are increasingly burdened with the emotional and practical care for their depressed relatives. However, informal family caregiving is mostly a stressful role with negative consequences on the physical and mental health of the caretakers to the extent that they...
Article
Full-text available
Background For relapse prevention in depression, conventional mindfulness programs such as the mindfulness-based cognitive therapy proved to be useful. However, early life trauma is a risk factor for having adverse experiences during meditation. Thus, for this patient group mindfulness skills are often difficult to learn and may be facilitated by u...
Article
Full-text available
Introduction: In depression treatment, most patients do not reach response or remission with current psychotherapeutic approaches. Major reasons for individual non-response are interindividual heterogeneity of etiological mechanisms and pathological forms, and a high rate of comorbid disorders. Personalised treatments targeting comorbidities as wel...
Article
Although abnormal resting state connectivity within several brain networks has been repeatedly reported in depression, little is known about connectivity in patients with early onset chronic depression. We compared resting state connectivity in a homogenous sample of 32 unmedicated patients with early onset chronic depression and 40 healthy control...
Article
Die Dysthymia wurde erstmals in den späten 1970er-Jahren in DSM-III als milde, chronisch verlaufende Depressionsform eingeführt, um den Begriff der „depressiven Persönlichkeit“ zu ersetzen. Das Konzept war von Anfang an Gegenstand heftiger Kontroversen und ist bis heute umstritten. Dieser Beitrag zeigt, welchen Herausforderungen Kliniker*innen bei...
Preprint
Full-text available
Introduction: In depression treatment, most patients do not reach response or remission with current psychotherapeutic approaches. Major reasons for individual non-response are interindividual heterogeneity of etiological mechanisms and pathological forms, and a high rate of comorbid disorders. Personalised treatments targeting comorbidities as wel...
Article
The founder of CBASP, James McCullough assumed that the interpersonal problems, which chronically depressed patients often experience, and which can fuel into the severity of the depression, have their roots in childhood maltreatment. These interpersonal problems also impair the relationship between patient and therapist and thereby impede effectiv...
Chapter
Die Dysthyme Störung (Dysthymie) ist eine anhaltende affektive Störung, die durch eine andauernde leichtgradige depressive Verstimmung über einen Zeitraum von mindestens 2 Jahren charakterisiert ist. Sie ist eine der häufigsten übersehenen und unbehandelten psychischen Störungen. Bei oftmals mangelndem Krankheitsbewusstsein führt Dysthymie bei den...
Chapter
Zusammenfassung: Das Cognitive Behavioral Analysis System of Psychotherapy (CBASP) ist einer der vielversprechendsten Ansätze als störungsspezifisches Psychotherapieverfahren für chronische Depression. Um die kurz-und langfristige Wirksamkeit von CBASP beurteilen zu können, liegen bislang jedoch nicht genügend Studienergebnisse mit ausreichend lang...
Article
Obwohl chronische Verläufe bei Depressionen häufig vorkommen (bis zu 30%), werden chronische und nicht-chronische Depressionsformen bis heute von Kliniker*innen und Wissenschaftler*innen diagnostisch oft nicht unterschieden. Eine differenzierte Diagnostik inklusive Erkrankungsbeginn, frühen Traumatisierungen, Komorbiditäten und Verlaufsmuster ist j...
Article
Objective This study explored whether treatment outcomes in a trial on the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) vs. Supportive Psychotherapy (SP) for patients with early-onset chronic depression differ between alliance patterns. Method Session-to-session ratings of the therapeutic alliance (Helping Alliance Questionnaire (...
Article
Full-text available
Importance: In the treatment of persistent depressive disorder (PDD), disorder-specific Cognitive Behavioral Analysis System of Psychotherapy (CBASP) has been shown to be superior to Supportive Psychotherapy (SP) in outpatients. It remains to clear which subgroups of patients benefit equally and differentially from both psychotherapies. Objective:...
Article
Full-text available
[In Press] According to the World Health Organization, cardiovascular diseases are the leading cause of death in the world. Therefore, early prevention of these diseases is a public health priority. Epidemiological data suggest that insomnia may be a modifiable risk factor for cardiovascular diseases. A randomised controlled trial in a sample of in...
Article
Anxiety and Depression in Transition - Desiderata for Improved Care and Research: Results of the Joint Task Force Transition of DGPPN and DGKJP Abstract. Affective disorders (e. g., anxiety, depression) frequently begin during adolescence. Yet therapeutic approaches during adolescence differ in some respects from those employed during adulthood. Du...
Preprint
Background: Looking back at more than 40 years of depression research including over 500 randomized trials, the efficacy of depression treatment is still unsatisfactory with less than half of the patients meeting criteria for response / remission (e.g. Cuijpers et al., 2014), and a high chronicity rate of up to 30% (e.g. Murphy & Byrne, 2012). In o...
Article
Background: Childhood maltreatment (CM) predicted poorer outcomes in acute depression treatment with CBT, IPT and Supportive Psychotherapy (SP). The Cognitive Behavioral Analysis System of Psychotherapy (CBASP) fared well in patients with chronic depression and CM during acute treatment, yet there is a considerable lack of empirical evidence for lo...
Article
Full-text available
Background: Depressive disorders are among the leading causes of sick leave and long-term work incapacity in most modern countries. Work related stress is described by patients as the most common context of depression. It is vital to know what types of treatments are effective in improving work related problems and occupational health. However, the...
Article
Background: Effective treatment requires regular follow-up and monitoring of symptoms. We investigated sensitivity to change and minimal clinically important difference of the Generalized Anxiety Disorder Scale (GAD-7). Methods: This study included all participants from a multisite trial of chronic depression. Baseline and follow-up (12 and 48 w...
Article
Persistent depressive disorder (PDD) is a chronic mood disorder that is common and often more disabling than episodic major depression. In DSM-5, the term subsumes a number of chronic depressive presentations, including dysthymia with or without superimposed major depressive episodes, chronic major depression, and recurrent major depression without...
Article
Full-text available
Objectives: Interpersonal problems were examined as moderators of depression outcomes between mindfulness-based cognitive therapy (MBCT) and cognitive behavioral analysis system of psychotherapy (CBASP) in patients with chronic depression. Methods: Patients received treatment-as-usual and, in addition, were randomized to 8-weeks of MBCT (n = 34)...
Article
Full-text available
Background: Late-life depression (LLD) is one of the most prevalent mental disorders in old age. It is associated with various adverse outcomes and frequent use of health care services thereby remaining a serious public health concern. Compared with depression in early adulthood, most treatment options of LLD are less effective. Psychotherapy may...
Article
Does the pre-treatment profile of individuals with persistent depressive disorder (PDD) moderate their benefit from disorder-specific Cognitive Behavioral System of Psychotherapy (CBASP) versus supportive psychotherapy (SP)? We investigated this question by analyzing data from a multi-center randomized clinical trial comparing the effectiveness of...
Article
Objectives: A recent trial comparing Cognitive Behavioral Analysis System of Psychotherapy (CBASP) and supportive psychotherapy in chronic depression found CBASP to be more effective in treating depressive symptoms. We aimed to evaluate adverse events that occurred during this trial. Materials and method: A randomized trial of chronically depres...
Article
Full-text available
Background: Evidence on the long-term efficacy of psychotherapeutic approaches for chronic depression is scarce. Objective: To evaluate the effects of the Cognitive Behavioral Analysis System of Psychotherapy (CBASP) compared to Supportive Psychotherapy (SP) 1 year and 2 years after treatment termination. Methods: In this study, we present 1-...
Article
Full-text available
Background Childhood maltreatment (CM) plays an important role in the development of major depressive disorder (MDD). The aim of this study was to examine whether CM severity and type are associated with MDD-related brain alterations, and how they interact with sex and age. Methods Within the ENIGMA-MDD network, severity and subtypes of CM using t...
Article
The cognitive behavioral analysis system of psychotherapy (CBASP) is designed specifically for chronic depression and is based on Donald Kiesler’s interpersonal model, with the role of the psychotherapist being administered from a disciplined personal involvement perspective. To achieve its learning goals, CBASP has been operationalized such that t...
Poster
Anlässlich der "Shortlisted Poster"-Präsentation am Tag der klinischen Forschung am Universitätsspital Basel am 24. Januar 2019 präsentiert.
Poster
Einleitung: Bei 20-30% der Patienten, die an einer Depression erkrankt sind, liegt ein chronischer Verlauf über mindestens zwei Jahre vor. Daraus ergibt sich eine Lebenszeitprävalenz der chronischen Depression (CD) von 3-6%. Patienten mit CD sind häufiger von Komorbiditäten und Suizidalität betroffen und sind häufiger arbeitslos als Patienten mit e...
Article
Objective: Childhood maltreatment, interpersonal fear and a specific kind of interpersonal skills deficit (preoperational thinking) have all been associated with persistent depressive disorder (PDD). We hypothesize that interpersonal fears mediate the association between childhood maltreatment and preoperational thinking. Method: A total of 108 mat...
Article
1 Background Persistent depressive disorder (PDD) is associated with high rates of comorbid psychiatric disorders, mostly anxiety disorders (ADs). Comorbid AD was found to be associated with poorer treatment outcome in PDD patients. The effect of comorbid AD on disorder‐specific treatment for PDD (Cognitive Behavioral Analysis System of Psychothera...
Article
Background: Persistent depressive disorder is prevalent, disabling, and often difficult to treat. The cognitive-behavioral analysis system of psychotherapy (CBASP) is the only psychotherapy specifically developed for its treatment. However, we do not know which of CBASP, antidepressant pharmacotherapy, or their combination is the most efficacious...
Article
Full-text available
Background: The Helping Alliance Questionnaire (HAQ) is a frequently used and highly relevant instrument to assess the therapeutic alliance. The questionnaire was translated into German by Bassler and colleagues (1995) and is available for patients (HAQ-P) and therapists (HAQ-T). Whereas the HAQ-P has been tested regarding psychometrics, the HAQ-T...
Article
Etwa ein Drittel aller depressiven Störungen nimmt einen chronischen Verlauf [1]. Chronische Depressionen gelten auch wegen der häufigen frühen Traumatisierungen und Komorbiditäten als schwer behandelbar. Die Betroffenen haben vor dem Hintergrund langjähriger widriger Beziehungserfahrungen in Kindheit und Jugend oft Schwierigkeiten, vertrauensvolle...
Article
Received: August 01, 2015 Accepted: October 20, 2017 Published online: January 06, 2018 Issue release date: January 2018
Article
Background: Persistent depressive disorder (PDD) is associated with high rates of comorbid personality disorders (PD). The association of comorbid PD and clinical characteristics has not been systematically studied in PDD. Results regarding effects on treatment outcome are heterogeneous. Methods: We analyzed the association of comorbid personali...
Article
Depression is a worldwide highly prevalent mental disorder. In national and international guidelines, psycho- and pharmacotherapy or their combination is recommended for its treatment. The short-term efficacy of these treatment options has been proved by many studies. However, only a few studies have investigated the lasting effect of the short-ter...
Article
Full-text available
Chronic depression is a highly prevalent and particularly disabling disorder. Due to the duration and a variety of complicating factors, chronic depression counts as difficult-to-treat. In treatment guidelines, a combination of psychotherapy and antidepressants is recommended for the treatment of persistent depressive disorders. Among different for...
Article
Zusammenfassung. Depressive Störungen stellen in der Allgemeinbevölkerung einer der häufigsten und wichtigsten Störungsgruppen dar. Speziell im Bereich der Psychotherapie sind in den letzten 20 Jahren vielfältige Entwicklungen erkennbar. Im Themenschwerpunkt dieses Heftes werden exemplarisch einige dieser Entwicklungen aufgezeigt.
Book
Das Ziel von CBASP ist es, dass Patienten erlernen, ihre persönlichen Bedürfnisse auch in schwierigen zwischenmenschlichen Situationen, durch angemessene Verhaltensfertigkeiten zum Ausdruck zu bringen. In diesem Therapie-Tool werden die vielfältigen Anwendungsmöglichkeiten von CBASP sehr breit abgedeckt und kreativ dargestellt. Zahlreiche Arbeits-...
Chapter
Full-text available
Kapitel 19.3 Tiergestützte Interventionen bei AD(H)S Seiten 305-313 Zusammen mit Andrea Beetz
Article
Objective: To evaluate the characteristics of suicide risk assessments completed using the Decision Tree framework both in and between psychotherapy sessions, clinical features of patients for whom between-session assessments are indicated, and data collected across assessments. Method: Data were collected from 1,358 suicide risk assessments con...
Article
Full-text available
Received: March 03, 2017 Accepted: April 29, 2017 Published online: September 14, 2017 Issue release date: October 2017
Article
Full-text available
The aetiology of suicidal behaviour is complex, and knowledge about its neurobiological mechanisms is limited. Neuroimaging methods provide a noninvasive approach to explore the neural correlates of suicide vulnerability in vivo. The ENIGMA-MDD Working Group is an international collaboration evaluating neuroimaging and clinical data from thousands...