Improving Quality of Life for Patients with Major Depressive Disorder by Increasing Hope and Positive Expectations with Future Directed Therapy (FDT).

OBJECTIVE Impaired quality of life is a significant problem for people with major depressive disorder and is often not addressed through symptom remediation alone. This study examines a new therapy for the treatment for depression that focuses on reducing hopelessness and increasing positive future anticipation, which are factors posited to contribute to quality of life. The new treatment was compared to depressed patients in the same setting treated with group cognitive behavioral therapy. DESIGN This study used a quasi-experimental design to examine the differences between future directed therapy and cognitive behavioral therapy on improving quality of life in patients with major depressive disorder. The main variables assessed at pre and post-treatment were quality of life, depressive symptoms, and hopelessness. SETTING Outpatient Department of Psychiatry Cedars-Sinai Medical Center Participants: Twenty-two patients completed the future directed therapy intervention and 20 patients completed the cognitive behavioral therapy intervention. MEASUREMENTS Patient-reported outcomes were collected using the Quick Inventory of Depressive Symptoms, the Beck Hopelessness Scale, and the Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form. RESULTS Though both treatments were effective at improving depression, hopelessness and positive future anticipation, those patients treated with future directed therapy demonstrated significant improvements in quality of life (p=0.002) while those treated in the cognitive behavioral therapy group did not (p=0.463). The magnitude of change for the main variables was significantly larger in the future directed therapy group and change in hopelessness and change in positive anticipation predicted change in quality of life in the future directed therapy group but not the cognitive behavioral therapy group. CONCLUSIONS Future directed therapy is a useful treatment for patients with major depressive disorder and quality of life impairment.