Changes in symptoms of depression during the course of therapy

Rabin, Adele S.; Kaslow, Nadine J.; Rehm, Lynn P.

doi:10.1007/bf01173285

Cited by 12 publications

(16 citation statements)

References 10 publications

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“…Week 4 At posttreatment, sudden gain patients had a mean PHQ-9 score of M = 5.3, SD = 3.63; whereas patients without sudden gains had a significantly higher mean of M = 10.2, SD = 6.8; t(35) = 2.92, p = .006. Rabin et al (1984) Week 3-4 NA NA For the majority of depressive symptoms, the largest changes occurred during the first 2 to 4 sessions.…”

Section: Heckman Et Al (2017)mentioning

confidence: 99%

“…Some of the reviewed studies did not specifically test early response-outcome associations, but instead focused on when the largest changes occurred, how many cases showed early response, or which variables predicted early response (Gildengers et al, 2005;Heckman et al, 2017;Jordan et al, 2014;Rabin et al, 1984). The key findings from these studies are summarized in Table 3.…”

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confidence: 99%

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Early response to psychological therapy as a predictor of depression and anxiety treatment outcomes: A systematic review and meta‐analysis

Beard

Delgadillo

2019

Depress Anxiety

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Background Previous studies indicate that early symptomatic improvement, typically observed during the first 4 weeks of psychological therapy, is associated with positive treatment outcomes for a range of mental health problems. However, the replicability, statistical significance, and magnitude of this association remain unclear. Aim The current study reviewed the literature on early response to psychological interventions for adults with depression and anxiety symptoms. Methods A systematic review and random effects meta‐analysis were conducted, including studies found in Medline, PsychINFO, SCOPUS, Web of Science, and through reference lists and reverse citations. Results Twenty‐five eligible studies including 11,091 patients measured early response and examined associations with posttreatment outcomes. It was possible to extract and/or calculate effect size data from 15 studies to conduct a meta‐analysis. A large pooled effect size (g = 0.87 [95% confidence interval: 0.63–1.10], p < .0001) indicated that early responders had significantly better posttreatment outcomes compared to cases without early response, and this effect was larger in anxiety (g = 1.37) compared to depression (g = 0.76) measures. Most studies were of good quality and there was no evidence of publication bias. The main limitations concerned insufficient statistical reporting in some studies, which precluded their inclusion in meta‐analysis, and it was not possible to examine effect sizes according to different outcome questionnaires. Conclusion There is robust and replicated evidence that early response to therapy is a reliable prognostic indicator for depression and anxiety treatment outcomes.

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Section: Heckman Et Al (2017)mentioning

confidence: 99%

mentioning

confidence: 99%

Early response to psychological therapy as a predictor of depression and anxiety treatment outcomes: A systematic review and meta‐analysis

Beard

Delgadillo

2019

Depress Anxiety

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“…Additionally, the overall climate of the family environment also has been linked to internalizing problems (Kaslow et al, 1984; Lau & Kwok, 2000; Sheeber et al, 2001). Higher levels of conflict and low levels of cohesiveness and expressiveness in the family have been found to be associated with higher levels of depressive symptoms in adolescents (e.g., Aydin & Oztütüncü, 2001; Sheeber, Hops, Alpert, Davis, & Andrews, 1997).…”

Section: Family Processes As Predictors Of Symptom Trajectoriesmentioning

confidence: 99%

“…Second, understanding how and when individual symptoms of depression change over time may provide clues to mechanisms underlying the disorder (Kendler, Zachar, & Craver, 2011). Third, determining the trajectories of the individual symptoms of depression can help clinicians decide which ones to target for early intervention and prevention (Conradi, Ormel, & de Jonge, 2011; Rabin, Kaslow, &Rehm, 1984; Sorensen, Nissen, Mors, & Thomsen, 2005). …”

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confidence: 99%

Trajectories of individual depressive symptoms in adolescents: Gender and family relationships as predictors.

Kouros

Garber

2014

Developmental Psychology

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Depressive syndrome and disorders increase substantially during adolescence. Little is known, however, about how individual symptoms of depression change over the course of this developmental period. The present study examined within-person changes in symptom severity of each individual symptom of depression, utilizing longitudinal data collected across six years of adolescence. Adolescent gender and family relationship variables were tested as predictors of the symptom trajectories (i.e., intercept and slope). Adolescents and their mothers (N = 240) were first evaluated when youth were in grade 6 (M = 11.86 years old; SD = 0.56; 54% female) and then annually through grade 12. Individual symptoms of depression were assessed by a clinical interviewer using the Children’s Depression Rating Scale-Revised (CDRS-R). Mothers and youth also completed measures about their relationship on the Children’s Report of Parent Behavior Inventory and the Family Environment Scale. Results showed that all depressive symptoms increased linearly over time except psychomotor disturbances and problems with concentration and decision making, which were best represented by a quadratic growth model. Sex differences were found such that significantly more rapid increases in worthlessness/guilt were found for girls than boys, and concentration/decision making problems decreased significantly for boys, but not girls. Poor family relationship quality (mother-reported) predicted a significantly faster rate of increase in adolescents’ symptoms of anhedonia, appetite/weight changes, and fatigue. High maternal psychological control (youth-reported) also predicted a faster rate of increase in anhedonia. Study limitations, future research directions, and clinical implications of the findings are discussed.

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“…Most studies that look at change over time during treatment for depression find that the greatest improvement occurs in the first few weeks of therapy. In a study by my research team of change during therapy (Rabin, Kaslow, & Rehm, 1984), we found that the largest change occurred between screening and the end of session one, and the majority of change during the first few weeks. It is at the beginning of therapy that people feel relief because help is coming, become optimism about improvement, and learn new ways to think about depression.…”

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confidence: 95%

Looking at the components of treatment for depression.

Rehm¹

2009

Clinical Psychology: Science and Practice

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This commentary reviews the Jacobson et al. (1996) article that is often cited as the basis for the current interest in behavioral activation (BA). It is argued that the results do not necessarily support the conclusion that BA is the essential component of cognitive therapy.Second, the commentary discusses the potential value of isolating components of complex treatment packages for depression and evaluating them for their match to the lives of individual depressed persons.

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Changes in symptoms of depression during the course of therapy

Cited by 12 publications

References 10 publications

Early response to psychological therapy as a predictor of depression and anxiety treatment outcomes: A systematic review and meta‐analysis

Early response to psychological therapy as a predictor of depression and anxiety treatment outcomes: A systematic review and meta‐analysis

Trajectories of individual depressive symptoms in adolescents: Gender and family relationships as predictors.

Looking at the components of treatment for depression.

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