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Low self-esteem has a negative influence on psychological symptoms like depression and anxiety and can cause patients to relapse after treatment. Research indicates that low self-esteem can even be a causal factor in developing psychiatric disorders like depression and anxiety. For this reason treatment should be focused more on changing low self-esteem instead of only treating the DSM-IV disorder. Cognitive interventions that focus on learning patients to formulate more positive and realistic thoughts, seem to be effective.