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the effectiveness of cbt in reducing depression a systematic review ira ayu maryuti 1faculty of nursing universitas airlangga iraayu maryuti gmail com keywords depression cognitive behavior therapy therapy depression abstract ...

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                         The Effectiveness of CBT In Reducing Depression: A Systematic 
                                                                           Review 
                                                                       Ira Ayu Maryuti 
                                                            1Faculty of Nursing Universitas Airlangga 
                                                                    iraayu.maryuti@gmail.com 
                    Keywords:       depression, cognitive behavior therapy, therapy depression. 
                    Abstract:       The purpose of making this Systematic Review is to evaluate effectiveness of Cognitive Behavioral Therapy 
                                    as a depression intervention in lowering depression levels. Keywords used, namely: depression, cognitive 
                                    behavior therapy, therapy depression. Journal article search is done electronically using multiple databases: 
                                    DOAJ, Sage, Proquest, JAMA Net, Google Scholar. The year limit used is 10 years (2007 -2017). From the 
                                    literature search results obtained fourteen selected journal articles. The thirteen studies raised in this study 
                                    all have control groups. There are 3 studies conducted at the age of the child, 9 studies in adulthood, 1 study 
                                    at the age of the elderly. In improving the next Systematic Review, it may be necessary to note the 
                                    homogeneity of age groups. So that more can focus in doing evaluation 
                    1     INTRODUCTION                                                  Cognitive  Therapy-  Behavior  is  a  therapy  that 
                                                                                    combines  cognitive  and  behavioral  aspects.  This 
                    Depression is a disturbance of feelings experienced             therapy  by  approaching  the  client  to  recognize 
                    by  individuals  of  different  ages  and  may  interfere       negative  thoughts  that  can  lead  to  negative 
                    with various aspects of life's functions, ranging from          perceptions  and  emotions.  Improper  thoughts  and 
                    motivation,  emotion,  cognitive,  behavioral,  and             emotions  will  affect  the  behavior  of  individuals, 
                    biological (Gilbert, 2000). Depression occurs in all            until it  is considered to require therapy (Kennerley 
                    ages  of  human  development,  ie  from  infancy  to            & Kirk, 2007). 
                    elderly. 
                        The  prevalence  of  depression  in  children  is 
                    estimated to be 0.5-2%. In certain populations it is            2    METHOD 
                    estimated to reach 10-20% with clinical problems. 
                    The cause of depression in children is not known for            Literature searches are performed in major databases 
                    certain,  but  this  can  lead  to  various  symptoms,          such  as  PROQUEST,  DOAJ,  SAGE,  JAMA  Net, 
                    among others: facial expressions sedi, easy to shed             and GOOGLE SCHOLAR by including keywords: 
                    tears,  irritability,  withdraw  from  the  interests  that     depression,  cognitive  behavior  therapy,  depression 
                    can usually be fun,                                             therapy. The time limit used is 2007 to 2017. Finally 
                        Interventions  to  overcome  depression  are  now           got  13  articles  that  meet  the  inclusion  criteria. 
                    widely      developed      through     biological     and       Inclusion  criteria  of  the  article  are:  1)  depressed 
                    psychological approaches, as well as a combination              patients,  2)  the  treatment  provided  is  cognitive 
                    of both. Both of these approaches proved effective              behavior  therapy,  3)  the  parameters  assessed  is 
                    for   treating  depression  in  the  elderly  (Das,             decreased depression level. 
                    Greenspan,  Muralee,  Choe  &  Tampi,  2007).  The                  Depression  rate  parameters  assessed  using  a 
                    biological  approach  is  done  by  administering               highly variable instrument. The instruments include: 
                    antidepressant     medicines     by    skilled   medical        using  Beck Depression Inventory (BDI), scalewas, 
                    personnel.     Psychological      approaches      include       locally  validated  versions  of  Posttraumatic  UCLA 
                    psychotherapy,  such  as  Cognitive  Behavioral                 Stress 
                    Therapy  (CBT),  Interpersonal  Therapy  (IPT),  and                Reaction     Disorder      Index     (range,    0-4). 
                    Dialectical Behavioral Therapy (DBT) therapy.                   nonparametrict Friedman or Wilcoxon standard on 
                    The 9th International Nursing Conference 2018                                                                       630 
                    “Nurses at The Forefront in Transforming Cre, Science, and research” 
                     
                    SPSS  software,  Geriatric  Depression  Scale  (GDS)            of depression, accidental sampling, 3 ) are willing to 
                    and Brief Depression rating Scale (BDRS.                        be respondents. The measuring tool used to assess 
                                                                                    the level of depression is Beck Depression Inventory 
                                                                                    (BDI).  The  intervention  was  conducted  in  6 
                    3     RESULT                                                    meetings,  with  1  pre-intervention  session,  8 
                                                                                    intervention    sessions,   and  1  post-intervention 
                    3.1     Depression in children                                  session. The meetings take place twice a week, each 
                                                                                    meeting  takes  60  minutes.  After  the  intervention 
                    Research  Dikla  Eckshtain  and  Scott  T.  Gaynor              there was a significant decrease in depression rates 
                    (2011)  stated  that  the  total  samples  meeting  the         in  2  participants,  but  in  another  participant,  the 
                    inclusion  criteria  were  as  many  as  15  children  in       decrease in depression was not significant, probably 
                    open clinical trials. The measuring tool used Scale             influenced by higher rates of depression early in the 
                    Revised  rating  is  semi  structured  interviews               assessment and a history of major depression. 
                    analyzed  using  standard  Friedman  or  Wilcoxon                   Research  conducted  by  Kenneth  E.  Freeland 
                    nonparametrictes  on  SPSS  software.  Cognitive                at.all (2010) states that the study was conducted in 
                    Behavioral  Therapy  (CBT)  using  16  session                  patients with depressed heart failure, and in getting 
                    combinations of 7 sessions. This study was followed             respondents as many as 158 people who meet the 
                    up for 1 month and 6 months after the intervention,             criteria of inclusion. The study was conducted in a 
                    which  resulted  in  a  significant  decrease  in               clinical  trial  with  a  single  blind  result.  After  6 
                    depression rate in all respondents.                             months  of  cognitive-behavioral  therapy,  73%  of 
                        The study of David A. Brend et al (2015) states             respondents  were  able  to  complete  with  lower 
                    that  a  total  sample  of  316  respondents  met  the          depression  score  on  Beck  Depression  Inventory 
                    inclusion  criteria.  Randomized  design  of  clinical          (BDI-II). 
                    trials.  CBT  interventions  are  given  weekly  for  90            Research  conducted  Elizabeth  O  Elizabeth 
                    minutes in 6 sessions. Scalewas gauges are used to              O'Connor  et.al  states  that  depression  screening  in 
                    measure  depression  levels.  After  follow-up  the             pregnant  and  postpartum  women, then there are 9 
                    results  showed  the  depression  rate  decreased               respondents  who  meet  the  inclusion  criteria.  This 
                    significantly.                                                  study  was  conducted  in  clinical  trials.  After 
                        Laurra  K.  Muray  et.al's  (2013)  study  indicated        Cognitive-Behavioral  therapy,  after  3-5  months 
                    that the total sample was 131 people as the treatment           follow-up  showed  that  there  was  a  decrease  in 
                    group,  and  126  as  the  control  group.  Design  a           depressive  symptoms  assessed  using  Postnatal 
                    randomized  clinical  trial  study  between  Cofnitive          Depression Scale. 
                    Behavioral  Therapy  (CBT)  interventions  with                     In the study of S. Darius Tandon et.al states that 
                    ordinary  care.  CBT  intervention  was  conducted  in          in the working population of adolescents and young 
                    10-16  sessions.  The  measuring  instrument  used  is          adults  the  need  for  mental  health  interventions  to 
                    using  locally  validated  versions  of  UCLA  Stress           reduce symptoms of depressive disorders. The study 
                    Posttraumatic Disorder Reaction Index (range, 0-4).             design     is    quasi-experimental      study.     After 
                    Results at follow up, mean item changes in symptom              recruitment  was  obtained  as  many  as  517 
                    trauma  score  were  -1.54  (95%  CI,  -1.81  -1.27),           respondents who meet kreiteria inclusion. Cognitive-
                    81.9% reduction, for TF-CBT and -0.37 ( 95% CI,                 Behavioral Therapy is done on site for 30 minutes, 
                    0.57 to-0.17), 21.1% reduction, for the TAU group.              this is done continuously for 1 year, then do follow-
                    The  mean  change  of  Item  for  a  function  is-0.76          up,  in  get  decrease  significantly  decrease  of 
                    (95% CI, -0.98 to -0.54), 89.4% reduction, and -0.54            symptoms of depression. 
                    (95% CI, 0.80 to -0.29 ), a reduction of 68.3%, for                 Evan M. Forman et.al (2007) stated that the total 
                    TF-CBT  and  TAU  groups,  respectively.  The                   respondents were given as many as 109 people. With 
                    difference  in  the  changes  between  the  groups  was         the  design  of  clinical  trials.  Interventions  of  CBT 
                    statistically significant for the outcome (p, 0.001).           and CT were performed. respondents were given the 
                                                                                    right to terminate therapy whenever they wanted, so 
                    3.2     Depression in adulthood                                 there were some respondents who did not complete 
                                                                                    the intervention until it was completed. Respondents 
                        Research Hapsarini Nelma (2012) states that the             who  performed  the  intervention  to  completion 
                    total  sample used is 1 (one) person that meets the             showed a significant decrease in depression rates, as 
                    inclusion  criteria  include:  1)  in  Diabetes  Mellitus       indicated by the results of BDI-II measurements. 
                    type 2 patient with GDP> 150mmhg, 2) experience 
                    The 9th International Nursing Conference 2018                                                                       631 
                    “Nurses at The Forefront in Transforming Cre, Science, and research” 
                         
                       Steven D. Hollon et.al (2014) states that the total       design doubleblind randomized clinical trials for 12 
                    number  of  respondents  who  met  the  inclusion            weeks. Having done DCS actions when combined 
                    criteria of 452 participants, 227 were randomized to         with CBT will give a significant effect. 
                    CT combined with ADM Treatment groups, and 225                   In  Meta  Analysis  Erica  S.  Weizt  et  al  (2014) 
                    for  the  treatment  of  group  ADMs  alone.  Patient        claimed to obtain abstract 14902 source data after 
                    designs were randomly assigned to ADM alone or               randomized  clinical  trials  where  and  ADM  were 
                    CT  treatment  combined  with  ADM  treatment.               compared  in  patients  with  depressive  disorders. 
                    Treatment  was  continued  for  42  months  until            shows  that  the  base  of  depression  severity  is 
                    recovery was achieved. The survival analysis based           notmoderate  reduction  in  depressive  symptoms 
                    on  the  hazard  subdistribution  model  used  for  the      between CBT and ADM in outcomes (β = 0.00; P = 
                    treatment   outcome  model.  cognitive  therapy              0.96).  The  same  result  is  seen  using  BDI.  Basic 
                    combined with drug treatment enhanced relative rate          depression severity is also not moderate probability 
                    of recovery relative to drug alone; These effects may        of response (OR, 0.99; P = 0.77) or remission (OR, 
                    be  limited  to  patients  with  severe  nonchronic          1.00; P = 0.93) between CBT and ADM. 
                    depression. 
                       Constance  Guille  et  al  (2015)  states  that  the      3.3    Depression in the elderly 
                    number  of  respondents  who  met  the  inclusion 
                    criteria  was  199.  Randomized  clinical  trial  design     Retna Arjadi's research (2012) states that the total 
                    was  conducted  at  2  university  hospitals  with  199      sample  used  is  3  (three)  elderly  people  who 
                    internships  from  several  specializations  during  the     experience  depression,  selected  by  accidental 
                    2009-2010 academic year or 2011-2012. The study              sampling. Measurements used to assess depression 
                    was  conducted  from  May  2009  to  June  2010  and         levels  are  Beck  Depression  Inventory  (BDI), 
                    May  2011  through  June  2012,  and  data  were             Geriatric  Depression  Scale  (GDS)  and  Brief 
                    analyzed  using  intent-to-treat  principles,  including     Depression rating scales (BDRS). Measurements are 
                    recent  observations.  INTERVENTION  Trainees                made at the beginning and end of CBT intervention. 
                    were randomly assigned to two study groups (wCBT             The intervention was conducted in 10 meetings, with 
                    and attention-control group [ACG ]), and completes           1  pre-intervention  session,  8  intervention  sessions, 
                    a study that lasts 30 minutes each week for 4 weeks          and 1 post-intervention session. The meetings take 
                    before starting the apprenticeship. The results show         place twice a week, each meeting takes 60 minutes. 
                    that there is a decrease in suicidal intentions.             After  the  intervention  there  was  a  significant 
                       Zindel V. Segal et.al (2010) states that the total        decrease in depression rates in 2 participants, but in 
                    number of respondents selected because menmenuhi             another participant, the decrease in depression was 
                    inclusion  criteria  as  many  as  160  people.  The         not significant, probably influenced by higher rates 
                    research design used was randomized for 18 months.           of depression early in the assessment and a history 
                    Patient's intervention in remission discontinues them        of major depression. 
                    antidepressants  and  attended  8  weekly  group 
                    sessions  of  MBCT,  continued  to  take  their 
                    therapeutic  doses  of  antidepressant  drugs,  or  the      4    CONCLUSIONS 
                    active drug was stopped and diverted to the placebo. 
                    Results:  The  intention-to-treat  analysis  showed          Cognitive  Behavioral Therapy (CBT) is a form of 
                    significant  interactions  between  the  acute  phase        mental exercise, especially depressed patients. CBT 
                    quality  of  remission  and  subsequent  prevention  of      makes  significant  improvements  in  the  depression 
                    relapse  in  randomized patients (P = 0.03). Among           therapy stage to practice over and over again. Of the 
                    the unstable delivery services (1 or more Hamilton           13  studies  examined  proved  that  CBT  could  be 
                    Rating  Scale  for  Depression  scored  7  during            another benefit found to reduce depression levels, it 
                    remission), patients in both MBCT and maintenance            is  expected to be an alternative in rehabilitation of 
                    treatments  showed  a  73%  decrease  in  hazard             depressed patients to achieve better quality of life.. 
                    compared to placebo (P = 0.03), while for delivery 
                    services  stable  (All  Hamilton Scale Rating  for the 
                    Depression score? 7 during remission) there  is  no          REFERENCES 
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...The effectiveness of cbt in reducing depression a systematic review ira ayu maryuti faculty nursing universitas airlangga iraayu gmail com keywords cognitive behavior therapy abstract purpose making this is to evaluate behavioral as intervention lowering levels used namely journal article search done electronically using multiple databases doaj sage proquest jama net google scholar year limit years from literature results obtained fourteen selected articles thirteen studies raised study all have control groups there are conducted at age child adulthood elderly improving next it may be necessary note homogeneity so that more can focus doing evaluation introduction combines and aspects disturbance feelings experienced by approaching client recognize individuals different ages interfere negative thoughts lead with various life s functions ranging perceptions emotions improper motivation emotion will affect biological gilbert occurs until considered require kennerley human development ie i...

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