The lac study: Chronic depression and relationship to childhood trauma

Abstract

In the multicenter LAC study, 554 chronic depressive patients were interviewed in four treatment centers, 252 of whom were enrolled in the study. The self-assessments of the patients (BDI) showed large and stable changes. The complete remission rate was 34% after 1 year and increased to 45% after 3 years. The effect sizes were d = 1.17 after 1 year and increased to 1.83 after 3 years. Analogous results were shown in the assessments of the independent, blinded raters (QIDS: remission rates after 1 year, 39%; after 3 years, 61%; effect strengths d = 1.56 after 1 year; d = 2.08 after 3 years). Contrary to their hypotheses, however, the authors found no statistically significant difference between the procedures with regard to symptom reduction and no effect differences between randomized treatment allocation and treatment. However, there were differences in the structure of the personality (measured with Operationalized Psychodynamic Diagnostics, OPD). Three years after the start of treatment, more patients in psychoanalytic treatments showed more changes in the structure of their personality than in cognitive-behavioral treatments. In addition, these structural changes in psychoanalytic therapy had a stronger influence on symptom change than in cognitive-behavioral therapy. These results-3 years after the start of treatment-were published in 2019. Currently, the results are evaluated 5 years after the start of treatment as well as other secondary measures of outcome-the book chapter summarizes these latest results and the study and combines them with considerations on the psychoanalytic treatment technique of this patient group. A detailed case study serves as illustration.