Schema therapy for patients with chronic depression: A single case series study

Ioannis A. Malogiannis*, Arnoud Arntz, Areti Spyropoulou, Eirini Tsartsara, Aikaterini Aggeli, Spyridoula Karveli, Miranda Vlavianou, Artemios Pehlivanidis, George N. Papadimitriou, Iannis Zervas

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background and objectives: This study tested the effectiveness of schema therapy (ST) for patients with chronic depression. Methods: Twelve patients with a diagnosis of chronic depression participated. The treatment protocol consisted of 60 sessions, with the first 55 sessions offered weekly and the last five sessions on a biweekly basis. A single case series A-B-C design, with 6 months follow-up was used. Baseline (A) was a wait period of 8 weeks. Baseline was followed by introduction to ST and bonding to therapist (phase B) with individually tailored length of 12-16 sessions, after which further ST was provided (phase C) up to 60 sessions (included the sessions given as introduction). Patients were assessed with Hamilton Rating Scale for Depression three times during baseline, at the end of phase B, then every 12 weeks until the end of treatment and at 6 months follow-up. Secondary outcome measures were the Hamilton Rating Scale for Anxiety and the Young Schema Questionnaire. Results: At the end of treatment 7 patients (approximately 60%) remitted or satisfactorily responded. The mean HRSD dropped from 21.07 during baseline to 9.40 at post-treatment and 10.75 at follow-up. The effects were large and the gains of treatment were maintained at 6-month follow-up. Only one patient dropped out for reasons not related to treatment. Limitations: The lack of control group, the small sample and the lack of a multiple baseline case series. Conclusions: This preliminary study supports the use of ST as an effective treatment for chronic depression.
Original languageEnglish
Pages (from-to)319-329
JournalJournal of Behavior Therapy and Experimental Psychiatry
Issue number3
Publication statusPublished - Sept 2014


  • Chronic depression
  • Schema therapy
  • CBT
  • Single case series
  • Early maladaptive schemas

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