Ten month outcome of cognitive behavioural therapy <i>v</i>. interpersonal psychotherapy in patients with major depression: a randomised trial of acute and maintenance psychotherapy

Mulder, Roger; Boden, Joseph M.; Carter, J; Luty, Suzanne E.; Joyce, Peter R.

doi:10.1017/s0033291717001106

Cited by 23 publications

(11 citation statements)

References 16 publications

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“…In previous randomized trials comparing CT and IPT head-to-head, various predictors and moderators of posttreatment outcome were identified (Sotsky et al, 1991;Joyce et al, 2007;Luty et al, 2007;Ryder et al, 2010;Carter et al, 2011;Mulder et al, 2017). Only one study by Mulder et al (2017) also identified predictors and moderators of longterm outcomes during maintenance CT and IPT following acute phase treatment. The findings of this study were not in line with our results: no significant moderators were identified, and personality variables were identified as significant predictors.…”

Section: Predictors and Moderatorsmentioning

confidence: 99%

Precision medicine for long-term depression outcomes using the Personalized Advantage Index approach: cognitive therapy or interpersonal psychotherapy?

et al. 2019

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Background Psychotherapies for depression are equally effective on average, but individual responses vary widely. Outcomes can be improved by optimizing treatment selection using multivariate prediction models. A promising approach is the Personalized Advantage Index (PAI) that predicts the optimal treatment for a given individual and the magnitude of the advantage. The current study aimed to extend the PAI to long-term depression outcomes after acute-phase psychotherapy. Methods Data come from a randomized trial comparing cognitive therapy (CT, n = 76) and interpersonal psychotherapy (IPT, n = 75) for major depressive disorder (MDD). Primary outcome was depression severity, as assessed by the BDI-II, during 17-month follow-up. First, predictors and moderators were selected from 38 pre-treatment variables using a two-step machine learning approach. Second, predictors and moderators were combined into a final model, from which PAI predictions were computed with cross-validation. Long-term PAI predictions were then compared to actual follow-up outcomes and post-treatment PAI predictions. Results One predictor (parental alcohol abuse) and two moderators (recent life events; childhood maltreatment) were identified. Individuals assigned to their PAI-indicated treatment had lower follow-up depression severity compared to those assigned to their PAI-non-indicated treatment. This difference was significant in two subsets of the overall sample: those whose PAI score was in the upper 60%, and those whose PAI indicated CT, irrespective of magnitude. Long-term predictions did not overlap substantially with predictions for acute benefit. Conclusions If replicated, long-term PAI predictions could enhance precision medicine by selecting the optimal treatment for a given depressed individual over the long term.

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Section: Predictors and Moderatorsmentioning

confidence: 99%

Precision medicine for long-term depression outcomes using the Personalized Advantage Index approach: cognitive therapy or interpersonal psychotherapy?

et al. 2019

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“…Two studies were drug trials, while the other two were psychotherapy studies. Details of each study are reported elsewhere (Carter et al, 2013;Joyce et al, 1994Joyce et al, , 2002Mulder et al, 2017).…”

Section: Samplementioning

confidence: 99%

“…Exclusion criteria were a diagnosis of schizophrenia, mania, severe substance use disorder (mild to moderate was acceptable) and significant physical illness. Two trials also excluded those who had not benefitted from psychotherapy over the prior year (Carter et al, 2013;Mulder et al, 2017). Participants were all recruited from the same geographic area, Canterbury, New Zealand, and were similar with regard to demographic and diagnostic variables.…”

Section: Samplementioning

confidence: 99%

The borderline pattern descriptor in the International Classification of Diseases, 11th Revision: A redundant addition to classification

Mulder

Horwood

Tyrer

2020

Aust N Z J Psychiatry

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Objective: The International Classification of Diseases, 11th Revision classification of personality disorder removes all categories of disorder in favour of a single diagnostic spectrum extending from no personality dysfunction to severe personality disorder. Following concerns from some clinicians and Personality Disorder Societies, it was subsequently agreed to include a borderline pattern descriptor as a qualifier of the main diagnosis. We explore the value of this additional descriptor by examining personality data in patients with major depression. Method: We examined personality data obtained using the Structured Clinical Interview for Personality Disorder-II in 606 patients enrolled in five randomised controlled trials of depression. The Structured Clinical Interview for Personality Disorder-II uses the Diagnostic and Statistical Manual of Mental Disorders categorical system, which includes borderline personality disorder. The International Classification of Diseases, 11th Revision classification has five domain traits. Each of the Diagnostic and Statistical Manual of Mental Disorders personality disorder symptoms or behaviours from Structured Clinical Interview for Personality Disorder-II was reordered into the five domains independently by two assessors. The relationship between the two systems was examined by tabular and correlational analysis. Results: The findings showed that the symptoms of borderline personality disorder were associated with greater severity of personality disturbance in the International Classification of Diseases, 11th Revision classification ( p < 0.0001) and were associated primarily with the Negative Affective, Dissocial and Disinhibited domains. There was only a weak association with the other two domains, Anankastia and Detachment. Conclusion: The addition of a borderline pattern descriptor is likely to add little to the International Classification of Diseases, 11th Revision classification of personality disorder. Its features are well represented within the severity/domain structure, which allows for more fine-grained description of the personality features that constitute the borderline concept.

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“… 3 , 4 To date, several alternative treatments are available, such as electroconvulsive therapy (ECT) and nonpharmacological treatments like cognitive behavior therapy or interpersonal psychotherapy. 5 ECT is used to induce neuromodulation, 6 which is highly effective in TRD with 60%–80% of patients achieving remission. 7 , 8 Interestingly, combination of ECT with aerobic exercise training ameliorates the remission rates of patients with MDD when compared with ECT alone.…”

Section: Introductionmentioning

confidence: 99%

Increased serum levels of sortilin-derived propeptide after electroconvulsive therapy in treatment-resistant depressed patients

Roulot¹,

Minelli²,

Bortolomasi³

et al. 2018

NDT

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PurposeSortilin-derived propeptide (PE) and its synthetic analog spadin show strong antidepressant activity in rodents and, therefore, could be used as a biomarker to evaluate the clinical efficacy of antidepressant treatments. The aim of this study was to determine whether electroconvulsive therapy (ECT) modulates serum PE concentration in patients with treatment-resistant depression (TRD).Patients and methodsForty-five patients with major depressive disorder, who met the Diagnostic and Statistical Manual of Mental Disorders-IV criteria, were selected for this study.ResultsWe did not observe any difference in the PE levels between TRD patients and controls (z=0.10, P=0.92), but we found a strong significant increase between the PE levels measured just before (T0) and about 1 month (T2) after ECT (z=−2.82, P=0.005). A significant difference between T0 and T2 was observed only in responders (z=−2.59, P=0.01), whereas no effect was found in nonresponders (z=−1.27, P=0.20). Interestingly, we found a significant correlation between the increase in PE levels and decrease in Montgomery -Åsberg Depression Rating Scale scores for the total patient sample (P=0.03).ConclusionThis study indicates for the first time that ECT affects serum PE concentration in responders and, therefore, could contribute to the evaluation of the therapy success.

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Ten month outcome of cognitive behavioural therapy v. interpersonal psychotherapy in patients with major depression: a randomised trial of acute and maintenance psychotherapy

Abstract: CBT and IPT are effective treatments for major depression over the longer term. CBT may work more quickly. Personality variables are the most relevant predictors of outcome.

Cited by 23 publications

References 16 publications

Precision medicine for long-term depression outcomes using the Personalized Advantage Index approach: cognitive therapy or interpersonal psychotherapy?

Precision medicine for long-term depression outcomes using the Personalized Advantage Index approach: cognitive therapy or interpersonal psychotherapy?

The borderline pattern descriptor in the International Classification of Diseases, 11th Revision: A redundant addition to classification

Increased serum levels of sortilin-derived propeptide after electroconvulsive therapy in treatment-resistant depressed patients

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