A positive future outlook is needed for depression suffers

A positive future outlook is needed for depression suffers

By Liz Lockhart

Learning to have a more positive outlook about the future, rather than focusing on negative thoughts of the past will cause patients with major depression to do better, say researchers at Cedars-Sinai after developing a new treatment that helps patients to do this.

Traditional treatment for patients with Major Depressive Disorder includes cognitive behaviour therapy (CBT).  CBT seeks to change irrational, negative thoughts about the past but patients treated with the newly-developed ‘Future-Directed Therapy’ demonstrated significant improvement in depression and anxiety.  There was also found to be improvement in overall reported quality of life according to the researchers.

The results of this study are published in the journal CNS Neuroscience & Therapeutics.

The study author, Jennice Vilhauer, Ph.D., director of Adult Outpatient Programmes for the Cedars-Sinai Department of Psychiatry and Behavioural Neurosciences said:

‘Recent imaging studies show that depressed patients have reduced functioning in the regions of the brain responsible for optimism.  Also people with depression tend to have fewer skills to help them develop a better future.  They have less ability to set goals, problem solve or plan for future events.’

Anand Pandya, MD, interim chair of Cedars-Sinai's Department of Psychiatry and Behavioral Neurosciences, said:

 ‘Future-Directed Therapy is designed to reduce depression by teaching people the skills they need to think more positively about the future and take the action required to create positive future experiences. This is the first study that demonstrates this intervention intended to increase positive expectations about the future can reduce symptoms of Major Depressive Disorder.’

Vilhauer added ‘Talking about what makes you unhappy in life doesn’t generate the necessary thinking patterns or action needed to promote a state of thriving and create a more positive future.  Future Directed Therapy helps people shift their attention, causing visions of what they want more of in the future and it helps them develop the skills that they will need to eventually get there.

The study was conducted at Cedars-Sinai.  Sixteen adult patients who had a diagnosis of Major Depressive Disorder attended future-directed group therapy sessions led by a licensed psychologist.  These sessions were help twice a week over a period of 10 weeks.  Every week patients read a chapter from a Future-Directed Therapy manual and then completed worksheets designed to improve certain skills such as goal-setting. 

A further group of 17 patients who had a previous diagnosis of depression, underwent standard cognitive group therapy. The researchers then measured the severity of depression and anxiety symptoms and quality of life before and after treatment.  This assessment involved the use of Quality-of-Life Enjoyment and Satisfaction Questionnaire short form.

The results include:

• Patients in the Future-Directed Therapy group experienced on average a 5.4 point reduction in their depressive symptoms on the Quick Inventory of Depressive Symptoms scale, compared to a two point reduction in the cognitive therapy group.
• Patients in the Future-Directed Therapy group on average reported a 5.4 point reduction in anxiety symptoms on the Beck Anxiety Inventory, compared to a reduction of 1.7 points in the cognitive therapy group.
• Patients in the Future-Directed Therapy group reported on average an 8.4 point improvement in their self-reported quality of life on the Quality of Life Enjoyment and Satisfaction scale, compared to a 1.2 point improvement in the cognitive therapy group.