Moderators of continuation phase cognitive therapy's effects on relapse, recurrence, remission, and recovery from depression.
About half of patients who respond to acute-phase cognitive therapy (CT) for major depressive disorder (MDD) will relapse/recur within 2 years; continuation-phase CT lowers this risk. We analyzed demographic, clinical, cognitive, social-interpersonal, and personality variables to clarify which patients continuation-phase CT helps to avoid relapse and recurrence and achieve remission and recovery. Participants had recurrent MDD, responded to acute-phase CT, were randomized to 8 months of continuation-phase CT (n = 41) or assessment control (n = 43), and were assessed 16 additional months (Jarrett et al., 2001). Consistent with an underlying risk-reduction model, continuation-phase CT was helpful for responders to acute-phase CT with greater risk and/or dysfunction as follows: Younger patients with earlier MDD onset who displayed greater dysfunctional attitudes and lower self-efficacy; personality traits suggesting low positive activation (e.g., reduced energy, enthusiasm, gregariousness); and transiently elevated depressive symptoms late in acute-phase CT and residual symptoms after acute-phase CT response. We emphasize the need for replication of these results before clinical application.
Vittengl
Jeffrey R
JR
Department of Psychology, Truman State University, 100 East Normal Street, Kirksville, MO 63501-4221, USA.
Clark
Lee Anna
LA
Jarrett
Robin B
RB
D000208:Acute Disease; D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003289:Convalescence; D003865:Major Depressive Disorder / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D017050:Episode of Care; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012074:Remission Induction; D018570:Risk Assessment; D055502:Secondary Prevention