Prevention of Recurrent Depression With Cognitive Behavioral Therapy

Fava, Giovanni A.; Rafanelli, Chiara; Grandi, Silvana; Conti, Sandra; Belluardo, Piera

doi:10.1001/archpsyc.55.9.816

Cited by 469 publications

(360 citation statements)

References 53 publications

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“…In addition, the inclusion criteria of eligible patients, such as previous interventions of these patients, in these trials were different as well. Two trials by Fava et al [46,49] implemented the intervention of CBT as described by Beck et al [60], while others respectively used their own manuals which were modified from that by Beck et al [60]. All the authors delivered CBT in face-to-face modality other than Holländare et al [52], who delivered it in the modules of internet communication and encrypted e-mails which largely decreased time of therapist.…”

Section: Cbtmentioning

confidence: 99%

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One-year outcomes of a randomized clinical trial treating depression in low-income minority women.

Miranda

Green

Krupnick

et al. 2006

Journal of Consulting and Clinical Psychology

112

102

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Background: The risk of relapse in major depressive disorder (MDD) is associated with high worldwide disease burden. Cognitive behavioral therapy (CBT) and its modifications might be effective in relapse prevention. The aim of this review was to evaluate the efficacy of these treatments for reducing relapse of MDD. Methods: The retrieval was performed in the databases of MEDLINE via Pubmed, EMBASE and PsycINFO via OVID, The Cochrane Library and four Chinese databases. Clinical trials registry platforms and references of relevant articles were retrieved as well. Hazard ratio (HR) and corresponding 95% confidence interval (CI) were used to pool evidences. Results: A total of 16 eligible trials involving 1945 participants were included. In the first 12 months, CBT was more efficacious than control in reducing the risk of developing a new episode of depression for MDD patients in remission (HR:0.50, 95%CI:0.35-0.72, I 2 = 11%). Mindfulness-based cognitive therapy (MBCT) was more efficacious than control only among patients with 3 or more previous depressive episodes (HR:0.46, 95%CI:0.31-0.70, I 2 = 38%). Besides, compared with maintenance antidepressant medication (m-ADM), MBCT was a more effective intervention (HR:0.76, 95%CI:0.58-0.98, I 2 = 0%). These positive effects might be only maintained at two and nearly 6 years follow up for CBT. Conclusion: The use of CBT for MDD patients in remission might reduce risk of relapse. Besides, the effect of MBCT was moderated by number of prior episodes and MBCT might only be effective for MDD patients with 3 or more previous episodes. Further exploration for the influence of previous psychological intervention is required.

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Section: Cbtmentioning

confidence: 99%

“…Only one trial by [49] reported subjects with 3 or more previous MDD episodes. They found that compared to control, CBT had a preventive effect (HR:0.31, 95%CI:0.10-0.97).…”

Section: Cbt Vs Controlmentioning

confidence: 99%

One-year outcomes of a randomized clinical trial treating depression in low-income minority women.

Miranda

Green

Krupnick

et al. 2006

Journal of Consulting and Clinical Psychology

112

102

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“…Treatment with cognitive therapy resulted in a significant reduction in recurrence rates at 4 years (35% versus 70%) (Fava et al, 1998a). After 6 years of follow-up (Fava et al, 1998b), 10 of the patients in the cognitive therapy group (50%) and 15 of the patients in conventional treatment (75%) had suffered relapses; however, this difference was not statistically significant. When multiple recurrences were considered, the patients submitted to cognitive therapy had significantly fewer episodes and responded to the same antidepressant used in the basal episode of the study.…”

Section: Prevention Of Relapsesmentioning

confidence: 92%

“…Because of its high prevalence and resulting disability (major depression is classified as the second greatest cause of disability, adjusted for years of life, in developed countries) (Murray & Lopez, 1996). The concern in preventing recurrences of MDE is relevant and has been the target of research both with pharmacological treatment and psychotherapy (Antonuccio et al, 1995;Fava et al, 1996;Fava et al, 1998a;Fava et al, 1998b;Hollon et al, 2005).…”

Section: Epidemiological Aspectsmentioning

confidence: 99%

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Cognitive Behavioral Therapy for Depression

Sudak¹

2012

Psychiatric Clinics of North America

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Antidepressant Monotherapy vs Sequential Pharmacotherapy and Mindfulness-Based Cognitive Therapy, or Placebo, for Relapse Prophylaxis in Recurrent Depression

Segal¹,

Bieling²,

Young³

et al. 2010

Arch Gen Psychiatry

374

298

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Context Mindfulness Based Cognitive Therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse. Objective To compare rates of relapse in remitted depressed patients receiving MBCT against maintenance antidepressant pharmacotherapy, the current standard of care Design Patients who met remission criteria following 8 months of algorithm informed antidepressant treatment were randomized to either: Maintenance Antidepressant Medication (M-ADM), MBCT or placebo (PLA) and were followed for 18 months. Setting Outpatient clinics at the Centre for Addiction and Mental Health, Toronto and St. Joseph’s Healthcare, Hamilton. Participants One hundred sixty patients aged 18 to 65 meeting DSM-IV for major depressive disorder with a minimum of 2 past episodes. Of these, 84 achieved remission (52.5%) and were assigned to one of the 3 study conditions. Interventions Remitted patients either discontinued their antidepressants and attended eight weekly group sessions of MBCT, continued on their therapeutic dose of antidepressant medication or discontinued active medication onto placebo. Main Outcome Measure Relapse was defined as a return, for at least 2 weeks, of symptoms sufficient to meet the criteria for major depression on Module A of the SCID. Results Intention to treat analyses revealed a significant interaction between the quality of acute phase remission and subsequent prevention of relapse in randomized patients (p = .03). Among unstable remitters (defined as 1 or more HRSD >7 during remission) patients in both MBCT and M-ADM showed a 73% decrease in hazard compared to PLA (p = .03), whereas for stable remitters (all HRSD ≤ 7 during remission) there were no group differences in survival. Findings remained significant after accounting for the effects of past depressive episodes on relapse. Conclusion For depressed patients who are unwilling or unable to tolerate long term maintenance antidepressant treatment, MBCT offers equivalent protection from relapse.

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Prevention of Recurrent Depression With Cognitive Behavioral Therapy

Cited by 469 publications

References 53 publications

One-year outcomes of a randomized clinical trial treating depression in low-income minority women.

One-year outcomes of a randomized clinical trial treating depression in low-income minority women.

Cognitive Behavioral Therapy for Depression

Antidepressant Monotherapy vs Sequential Pharmacotherapy and Mindfulness-Based Cognitive Therapy, or Placebo, for Relapse Prophylaxis in Recurrent Depression

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