Cognitive-Behavioral Therapy as Continuation Treatment to Sustain Response After Electroconvulsive Therapy in Depression: A Randomized Controlled Trial

Brakemeier, Eva‐Lotta; Merkl, Angela; Wilbertz, Gregor; Quante, Arnim; Regen, Francesca; Bührsch, Nicole; Hall, Franziska van; Kischkel, Eva; Danker‐Hopfe, Heidi; Anghelescu, Ion; Heuser, Isabella; Kathmann, Norbert; Bajbouj, Malek

doi:10.1016/j.biopsych.2013.11.030

Cited by 107 publications

(72 citation statements)

References 39 publications

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“…This suggestion is in line with the study by Wiersma et al [6] and the recommendations of authors and guidelines for not only more intensive but also more extended treatment courses [28]. Thus, these patients might benefit from continuation treatment starting directly after discharge, most suitably a combination of CBASP and pharmacotherapy [29,30]. Our relapse rates are relatively low taking into consideration the chronicity and treatment resistance of the sample and comparing these rates with other studies [30,31].…”

Section: Discussionsupporting

confidence: 73%

“…Thus, these patients might benefit from continuation treatment starting directly after discharge, most suitably a combination of CBASP and pharmacotherapy [29,30]. Our relapse rates are relatively low taking into consideration the chronicity and treatment resistance of the sample and comparing these rates with other studies [30,31]. However, relapse rates might be even more reduced by continuation treatment [29,30].…”

Section: Discussionmentioning

confidence: 99%

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Overcoming Treatment Resistance in Chronic Depression: A Pilot Study on Outcome and Feasibility of the Cognitive Behavioral Analysis System of Psychotherapy as an Inpatient Treatment Program

Brakemeier

Radtke²,

Engel³

et al. 2014

Psychother Psychosom

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Background: The Cognitive Behavioral Analysis System of Psychotherapy (CBASP), initially developed as an outpatient treatment for chronic depression (CD), has been adapted as a multidisciplinary 12-week inpatient program for CD. Methods: Seventy inpatients with CD and treatment resistance were included in a noncontrolled trial. The Hamilton Depression Rating Scale served as the primary outcome measure. Prospective naturalistic follow-up assessments were conducted 6 and 12 months after discharge. Results: Dropout rate was 7.1%; 90.4% perceived the program as helpful. Pre-post comparisons yielded strong effect sizes; 75.7% of the intention-to-treat sample responded, and 40.0% remitted. Nonremission was associated with experiencing temporary deterioration of symptoms during treatment. After 6 months 75.0% and after 12 months 48.0% of patients sustained response. Conclusions: The CBASP program appears as a feasible acute treatment for treatment-resistant CD inpatients with promising outcome. However, the continuation of treatment after discharge should be optimized especially for patients with subjective deterioration during treatment.

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Overcoming Treatment Resistance in Chronic Depression: A Pilot Study on Outcome and Feasibility of the Cognitive Behavioral Analysis System of Psychotherapy as an Inpatient Treatment Program

Brakemeier

Radtke²,

Engel³

et al. 2014

Psychother Psychosom

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“…Of these 89 studies, 24 were RCTs (Abdallah, Fasula, Kelmendi, Sanacora, & Ostroff, 2012;Abdollahi et al, 2012;Bailine et al, 2010;Bjølseth et al, 2015;Brakemeier et al, 2014;Ghasemi et al, 2014;Hansen et al, 2011;Kayser et al, 2011;Kellner et al, 2010;Keshtkar, Ghanizadeh, & Firoozabadi, 2011;Kumar, Sharma, & Mani, 2012;Loo et al, 2012;Loo et al, 2015;Masoudzadeh, Yahyavi, Rashidi, Mohammadpour, & Kiani, 2013;Matthews et al, 2013;Mayur, Bray, Fernandes, Bythe, & Gilbett, 2010;Mayur, Byth, & Harris, 2013;Purtuloglu et al, 2013;Quante et al, 2011;Roepke et al, 2011;Spaans et al, 2013;Wang et al, 2012;Yildiz et al, 2010;Yoosefi et al, 2014); and five were non-randomized trials (Allen et al, 2015;Aten, Oudega, van Exel, Stek, & van Waarde, 2015;Gedge et al, 2012;Lin et al, 2014;Okamoto et al, 2010).…”

Section: Focus and Design Of The 91 Studiesmentioning

confidence: 99%

“…Four of these were uninformative about the long term effects on ECT recipients in general, because data beyond the treatment period were selectively reported only for those individuals who responded, or remitted, during treatment (Brakemeier et al, 2014;Lucca et al, 2010;McCall et al, 2013;Yildiz et al, 2010), Two other studies did not report whether the level of difference at follow up was statistically significant and one study did not analyze the follow up data due to small numbers (Loo et al, 2012;Loo et al, 2015;Rapinesi et al, 2013).…”

Section: Changes In Depression Beyond the Treatment Periodmentioning

confidence: 99%

Is Electroconvulsive Therapy for Depression More Effective Than Placebo? A Systematic Review of Studies Since 2009

Read

Arnold

2017

Ethical Hum Psychol Psychiatry

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Is electroconvulsive therapy for depression more effective than placebo? A systematic review of studies since 2009. ABSTRACTBackground: A 2010 review of studies and previous reviews and meta-analyses found minimal evidence that ECT for depression was more effective than placebo during the treatment period and no evidence at all of efficacy beyond the end of treatment. The current review explored whether any contradictory evidence has since been generated. Method: MEDLINE and PsycINFO were searched to identify all post 2009 studies that had compared ECT and simulated ECT for depression, or had in any other way generated valid depression data for ECT recipients at two or more points in time. Results: Ninety-one studies met inclusion criteria. There were no new placebo-controlled trials. There have now been no such studies since 1985. Only four placebo-controlled studies have ever produced data beyond the end of treatment, none of which had found any advantage for ECT over placebo. Of the 91 studies only two aimed to evaluate the efficacy of ECT. Both were severely flawed. None of the other 89 produced robust evidence that ECT is effective for depression, primarily because at least 60% maintained ECT participants on medication and 89% produced no meaningful follow up data beyond the end of treatment. No studies investigated whether ECT prevents suicide. Conclusions: There is still no evidence that ECT is more effective than placebo for depression reduction or suicide prevention. Given the 1 well-documented high risk of persistent memory dysfunction, the cost-benefit analysis for ECT remains so poor that its use cannot be scientifically, or ethically, justified.

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“…The efficacy of ultra-brief pulse right unilateral (RUL) ECT needs to be carefully evaluated given its more benign cognitive side effect profile than standard pulse width ECT and bilateral (BL) electrode placement (22). In the past year, studies have questioned the efficacy of ultra-brief pulse RUL in relapse prevention (23,24) and failed to demonstrate a cognitive advantage relative to standard pulse width (25). However, issues of proper dosing, adequate study design, and optimal measurement sensitive enough to capture relative advantages in cognitive side effects are clearly important before making conclusions about the clinical value of ultra-brief RUL ECT (26).…”

Section: Electrical and Magnetic Seizure Therapies Ect In Major Deprementioning

confidence: 99%

Recent Developments in Noninvasive Neuromodulation for Mood and Anxiety Disorders

Rakesh

Lisanby

2015

Curr Behav Neurosci Rep

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Noninvasive neuromodulation refers to a family of device-based interventions that apply electrical or magnetic fields, either at convulsive or subconvulsive levels, to the brain through the intact skull to modulate neural function. This is a rapidly evolving field, with new research emerging regarding the various roles that these devices can play both in studying the neural mechanisms underlying mood and anxiety disorders, and in treating pharmacoresistant conditions either on their own or in combination with other therapies. Each neuromodulation modality has its pros and cons and should be carefully chosen after weighing the risks and benefits. This manuscript reviews some of the most exciting developments in this field over the past year and emphasizes themes that are emerging as being important for these tools to fulfill their potential to transform how we study and treat mood and anxiety disorders. Key among these themes is the concept of how we understand the "dose" of the stimulation, and how exogenously applied fields interact with endogenous brain activity. Refining the concept of dose will ultimately be important in allowing clinicians and researchers to apply the procedure with precision to engage the targeted network to achieve the desired effects in each individual. The large parameter space defining dose of neuromodulation makes interpreting the literature on safety and efficacy challenging and highlights the need for clear and accurate reporting of the spatial, temporal, and contextual features of dosage to make the emerging literature base as informative as possible. Ultimately, the impact of noninvasive neuromodulation devices is potentially transformational given their utility in providing mechanistic insight into the circuitbased and oscillatory origins of mood and anxiety disorders, as well as providing therapeutic interventions rationally designed to target disease-related processes.

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Cognitive-Behavioral Therapy as Continuation Treatment to Sustain Response After Electroconvulsive Therapy in Depression: A Randomized Controlled Trial

Cited by 107 publications

References 39 publications

Overcoming Treatment Resistance in Chronic Depression: A Pilot Study on Outcome and Feasibility of the Cognitive Behavioral Analysis System of Psychotherapy as an Inpatient Treatment Program

Overcoming Treatment Resistance in Chronic Depression: A Pilot Study on Outcome and Feasibility of the Cognitive Behavioral Analysis System of Psychotherapy as an Inpatient Treatment Program

Is Electroconvulsive Therapy for Depression More Effective Than Placebo? A Systematic Review of Studies Since 2009

Recent Developments in Noninvasive Neuromodulation for Mood and Anxiety Disorders

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