Long-term effects of a cognitive-behavioral training program for the management of depressive symptoms among patients in orthopedic inpatient rehabilitation of chronic low back pain: a 2-year follow-up.

The aim of the present study was to investigate the 2-year outcome of a cognitive-behavioral training program for the management of depressive symptoms for patients with chronic low back pain (CLBP) and co-existing depressive symptoms compared with the standard rehabilitation. Therefore, a quasi-experimental 3 × 2 × 5 (treatment condition × gender × time) repeated measures design with five assessment points (pre-treatment, post-treatment, 6-, 12-, and 24-month follow-up) was employed among N = 153 patients with CLBP, aged 33-62 years. Patients were consecutively assigned to one of three treatment conditions: patients with no or mild depressive symptoms were treated with the standard rehabilitation (CG) and patients with moderate or severe depressive symptoms were either treated with the standard rehabilitation (CG(depr)) or the standard rehabilitation plus cognitive-behavioral management of depressive symptoms (IG(depr)). Patients in the IG(depr) significantly improved in mental health up to the 6-month follow-up and in anxiety and depressive symptoms up to the 24-month follow-up. Only short- or mid-term improvements were found in the CG(depr). In conclusion, the new cognitive-behavioral training program augmented the long-term rehabilitation success in this highly strained subgroup of patients with CLBP and depressive symptoms.