Prevention of Recurrent Depression With Cognitive Behavioral Therapy: Preliminary Findings
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TLDR
The results challenge the assumption that long-term drug treatment is the only tool to prevent relapse in patients with recurrent depression and suggest CBT offers a viable alternative for other patients.Abstract:
Background Cognitive behavioral treatment (CBT) of residual symptoms after successful pharmacotherapy yielded a substantially lower relapse rate than did clinical management in patients with primary major depressive disorders. The aim of this study was to test the effectiveness of this approach in patients with recurrent depression (≥3 episodes of depression). Methods Forty patients with recurrent major depression who had been successfully treated with antidepressant drugs were randomly assigned to either CBT of residual symptoms (supplemented by lifestyle modification and well-being therapy) or clinical management. In both groups, during the 20-week experiment, antidepressant drug administration was tapered and discontinued. Residual symptoms were measured with a modified version of the Paykel Clinical Interview for Depression. Two-year follow-up was undertaken, during which no antidepressant drugs were used unless a relapse ensued. Results The CBT group had a significantly lower level of residual symptoms after discontinuation of drug therapy compared with the clinical management group. At 2-year follow-up, CBT also resulted in a lower relapse rate (25%) than did clinical management (80%). This difference attained statistical significance by survival analysis. Conclusions These results challenge the assumption that long-term drug treatment is the only tool to prevent relapse in patients with recurrent depression. Although maintenance pharmacotherapy seems to be necessary in some patients, CBT offers a viable alternative for other patients. Amelioration of residual symptoms may reduce the risk of relapse in depressed patients by affecting the progression of residual symptoms to prodromes of relapse.read more
Citations
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References
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Book
Cognitive Therapy of Depression
Steven D. Hollon,Aaron T. Beck +1 more
TL;DR: Hollon and Shaw as discussed by the authors discuss the role of emotions in Cognitive Therapy and discuss the integration of homework into Cognitive Therapy, and discuss problems related to Termination and Relapse.
Journal ArticleDOI
A Diagnostic Interview: The Schedule for Affective Disorders and Schizophrenia
Jean Endicott,Robert L. Spitzer +1 more
TL;DR: Initial scale development and reliability studies of the items and the scale scores are reported on.
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Bruce S. McEwen,Eliot Stellar +1 more
TL;DR: A new formulation of the relationship between stress and the processes leading to disease is presented, emphasizing the cascading relationships between environmental factors and genetic predispositions that lead to large individual differences in susceptibility to stress and, in some cases, to disease.
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TL;DR: The Fourth Edition of Statistical Methods for Survival Data Analysis is an ideal text for upper-undergraduate and graduate-level courses on survival data analysis and is an excellent resource for biomedical investigators, statisticians, and epidemiologists, as well as researchers in every field in which the analysis of survival data plays a role.