Comparison of changes in stress coping strategies between cognitive behavioral therapy and pharmacotherapy

Sakae Ihara; Nariko Katayama; Waka Nogami; Mizuki Amano; Sachiko Noda; Chika Kurata; Yuki Kobayashi; Yohei Sasaki; Dai Mitsuda; Mire Ozawa; Jun Matsuoka; Ryo Takemura; Hiroyuki Uchida; Atsuo Nakagawa

doi:10.3389/fpsyt.2024.1343637

Comparison of changes in stress coping strategies between cognitive behavioral therapy and pharmacotherapy

Front Psychiatry. 2024 Apr 15:15:1343637. doi: 10.3389/fpsyt.2024.1343637. eCollection 2024.

Authors

Sakae Ihara^{1

2

3}, Nariko Katayama¹, Waka Nogami¹, Mizuki Amano^{1

4}, Sachiko Noda¹, Chika Kurata¹, Yuki Kobayashi¹, Yohei Sasaki¹, Dai Mitsuda¹, Mire Ozawa¹, Jun Matsuoka^{1

3

5}, Ryo Takemura⁶, Hiroyuki Uchida¹, Atsuo Nakagawa^{1

6

7}

Affiliations

¹ Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan.
² Department of Psychiatry, Tokyo-Adachi Hospital, Tokyo, Japan.
³ Department of Psychiatry, Higashi-Omiya Mental Health Clinic, Saitama, Japan.
⁴ Department of Psychiatry, Toyosato Hospital, Tsukuba, Japan.
⁵ Department of Psychiatry, Ogu Mental Health Clinic, Tokyo, Japan.
⁶ Clinical and Translational Research Center, Keio University Hospital, Tokyo, Japan.
⁷ Department of Neuropsychiatry, St. Marianna University School of Medicine, Kawasaki, Japan.

Abstract

Background: Coping refers to conscious responses to negative circumstances, with the intention of ameliorating these situations. Few studies have compared the differences between psychotherapy and medication treatment for coping strategies for depression. In this study, we investigated the differences in coping strategies between cognitive behavioral therapy (CBT) combined with medication (CBT group) and medication alone (pharmacotherapy group) among outpatients with depression.

Methods: A prospective observational study was conducted among 50 patients with major depression (24 and 26 in the CBT and pharmacotherapy groups, respectively). Stress coping strategies (Coping Inventory for Stressful Situations [CISS]) and depression severity (Beck Depression Inventory-Second Edition [BDI-II]) were assessed at baseline and 16 weeks later. Changes in the CISS and BDI-II scores in both groups were tested using repeated analysis of variance. Inverse probability weighting with propensity score analysis was applied to address potential selection bias.

Results: At 16 weeks, the CBT group exhibited increased CISS task-oriented coping, distraction, and social diversion scores, which differed from those of the pharmacotherapy group. The CBT group exhibited a significantly greater reduction in depressive symptoms than the pharmacotherapy group.

Limitations: This study was not a randomized controlled trial and thus may have selection bias.

Conclusion: Gaining adaptive coping skills, including task-oriented coping, distraction, and social diversion skills, by combining CBT with medication may lead to greater improvement in depression symptoms. These findings suggest that clinicians should evaluate coping strategies and facilitate the acquisition of adaptive coping strategies in patients with depression to reduce their symptoms.

Keywords: cognitive behavioral therapy; depression; distraction; social diversion; task-oriented coping.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This research was supported by the Japan Society for the Promotion of Science KAKENHI (grant nos. JP21K13711 and JP21K15717) and Takeda Japan Medical Office Funded Research Grant 2022. The funding agencies were not involved in the study design, data collection, analysis, interpretation, manuscript writing, or in the decision to submit the paper.