Cognitive-Behavioral Analysis System of Psychotherapy as a Maintenance Treatment for Chronic Depression.

Klein, Daniel N.; Santiago, Neil J.; Vivian, Dina; Blalock, Janice A.; Kocsis, James H.; Markowitz, John C.; McCullough, James P.; Rush, A. John; Trivedi, Madhukar H.; Arnow, Bruce A.; Dünner, David L.; Manber, Rachel; Rothbaum, Barbara O.; Thase, Michael E.; Keitner, Gabor I.; Miller, Ivan W.; Keller, Martin B.

doi:10.1037/0022-006x.72.4.681

Cited by 118 publications

(47 citation statements)

References 22 publications

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“…Depressive relapse/recurrence is difficult to prevent using antidepressants only [5]. Cognitive therapy (CT) after the acute phase of depression reduces the risk of relapse [6,7,8,9,10,11,12]. In addition, brief psychotherapy, i.e.…”

Section: Introductionmentioning

confidence: 99%

The Three-Month Effect of Mobile Internet-Based Cognitive Therapy on the Course of Depressive Symptoms in Remitted Recurrently Depressed Patients: Results of a Randomized Controlled Trial

Kok¹,

Burger

Riper

et al. 2015

Psychother Psychosom

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Background: Internet-based cognitive therapy with monitoring via text messages (mobile CT), in addition to treatment as usual (TAU), might offer a cost-effective way to treat recurrent depression. Method: Remitted patients with at least 2 previous episodes of depression were randomized to mobile CT in addition to TAU (n = 126) or TAU only (n = 113). A linear mixed model was used to examine the effect of the treatment condition on a 3-month course of depressive symptoms after remission. Both an intention-to-treat analysis (n = 239) and a completer analysis (n = 193) were used. Depressive symptoms were assessed using the Inventory of Depressive Symptomatology (IDS-SR₃₀) at baseline and 1.5 and 3 months after randomization. Results: Residual depressive symptoms showed a small but statistically significant decrease in the intention-to-treat group over 3 months in the mobile CT group relative to the TAU group (difference: -1.60 points on the IDS-SR₃₀ per month, 95% CI = -2.64 to -0.56, p = 0.003). The effect of the treatment condition on the depressive symptomatology at the 3-month follow-up was small to moderate (Cohen's d = 0.44). All analyses among completers (≥5 modules) showed more pronounced treatment effects. Adjustment for unequally distributed variables did not markedly affect the results. Conclusions: Residual depressive symptoms after remission showed a more favorable course over 3 months in the mobile CT group compared to the TAU group. These results are a first indication that mobile CT in addition to TAU is effective in treating recurrently depressed patients in remission. However, demonstration of its long-term effectiveness and replication remains necessary.

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Section: Introductionmentioning

confidence: 99%

The Three-Month Effect of Mobile Internet-Based Cognitive Therapy on the Course of Depressive Symptoms in Remitted Recurrently Depressed Patients: Results of a Randomized Controlled Trial

Kok¹,

Burger

Riper

et al. 2015

Psychother Psychosom

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“…Averaging separately by treatment type yielded relapse-recurrence rates of 12% (1.2% per month; C-CT) and 38% (4.0% per month; nonactive controls) over a mean of 41 weeks. One included study, Klein et al (2004), tested a form of maintenance CT by excluding patients who relapsed during a continuation phase of the same treatment. The other included studies (Jarrett et al, 1998(Jarrett et al, ,2000(Jarrett et al, ,2001) evaluated C-CT implemented immediately after A-CT.…”

mentioning

confidence: 99%

Reducing relapse and recurrence in unipolar depression: A comparative meta-analysis of cognitive-behavioral therapy's effects.

Vittengl¹,

Clark²,

Dunn³

et al. 2007

Journal of Consulting and Clinical Psychology

493

378

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Relapse and recurrence following response to acute-phase treatment for major depressive disorder (MDD) are prevalent and costly. In a meta-analysis of 28 studies including 1,880 adults, the authors reviewed the world's published literature on cognitive-behavioral therapies (CT) aimed at preventing relapse-recurrence in MDD. Results indicate that after discontinuation of acute-phase treatment, many responders to CT relapse-recur (29% within 1 year and 54% within 2 years). These rates appear comparable to those associated with other depression-specific psychotherapies but lower than those associated with pharmacotherapy. Among acute-phase treatment responders, continuation-phase CT reduced relapse-recurrence compared with assessment only at the end of continuation treatment (21% reduction) and at follow-up (29% reduction). Continuation-phase CT also reduced relapserecurrence compared with other active continuation treatments at the end of continuation treatment (12% reduction) and at follow-up (14% reduction). The authors discuss implications for research and patient care and suggest directions, with methodological refinements, for future studies. Keywordsdepression; relapse and recurrence; cognitive-behavioral therapy; continuation and maintenance treatment; meta-analysis High prevalence and frequent relapse and recurrence amplify the public health significance of major depressive disorder (MDD). Epidemiological estimates place the lifetime prevalence of MDD at more than 16% (Kessler, Berglund, Demler, Jin, & Walters, 2005), and 14% of primary-care patients meet criteria for a major depressive episode (MDE; Ansseau et al., 2004). The large majority of individuals with MDD experience more than one MDE (Judd, 1997;Mueller et al., 1999), and the probability of another MDE increases with each relapserecurrence (Solomon et al., 2000; American Psychiatric Association, 2000a). For example, perhaps 85% of people who recover from an MDE will experience a second MDE within 15 years of naturalistic follow-up, and each additional episode increases the risk of relapserecurrence by 18% (Mueller et al., 1999). Consequently, life interference (e.g., lost work productivity, mortality, lower quality of life) due to MDD rivals that of other chronic diseases such as cancer, diabetes, and heart disease (Murray & Lopez, 1996;Simon, 2003), and most people who commit suicide are depressed (Fawcett, 1993).CorrespondenceThe risk of suicide and life interference can be reduced by shortening the duration of MDEs with effective acute-phase treatments, including pharmacotherapy, interpersonal psychotherapy, and cognitive-behavioral therapy (CT; Hollon, Jarrett, et al., 2005). We define acute-phase treatments as those applied during an MDE with the goal of reducing depressive symptoms and producing initial remission. Responders to some acute-phase treatments (e.g., CT) may receive some protection from relapse-recurrence (Hollon, Thase, & Markowitz, 2002), but prevalent relapse-recurrence after successful antidepressant treatments has ...

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“…In the 16-week continuation phase of treatment, 57 a greater number of patients maintained partial or full remission on the combination treatment (90%) as compared with the pharmacotherapy (80%) or psychotherapy alone (82%). In the 1-year maintenance phase of treatment, 58 patients in the CBASP group had significantly fewer recurrences (p ≤ .03) than those patients in the assessment-only group. Patients who receive psychotherapy in the acute and continuation phases of treatment and achieve remission may be at a lower risk for recurrence during the maintenance phase of treatment than those patients who do not receive psychotherapy.…”

mentioning

confidence: 95%

“…Zajecka: In the early phases of treatment, CBT may prevent relapse, even in patients who discontinue their medication. 54,55 Dr. Keller: Compelling evidence for the value of psychotherapy is provided by a 3-phase study-acute, continuation, and maintenance treatment phases [56][57][58] -that used a modified form of CBT called CBASP. In the 12-week acute phase of treatment, 56 patients randomly assigned to CBASP plus pharmacotherapy had a greater improve-ment in psychosocial functioning and higher remission rates than patients who received pharmacotherapy or psychotherapy alone.…”

mentioning

confidence: 99%

Preventing Recurrent Depression: Long-Term Treatment for Major Depressive Disorder

2007

Prim. Care Companion J. Clin. Psychiatry

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Cognitive-Behavioral Analysis System of Psychotherapy as a Maintenance Treatment for Chronic Depression.

Cited by 118 publications

References 22 publications

The Three-Month Effect of Mobile Internet-Based Cognitive Therapy on the Course of Depressive Symptoms in Remitted Recurrently Depressed Patients: Results of a Randomized Controlled Trial

The Three-Month Effect of Mobile Internet-Based Cognitive Therapy on the Course of Depressive Symptoms in Remitted Recurrently Depressed Patients: Results of a Randomized Controlled Trial

Reducing relapse and recurrence in unipolar depression: A comparative meta-analysis of cognitive-behavioral therapy's effects.

Preventing Recurrent Depression: Long-Term Treatment for Major Depressive Disorder

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