title: Outcomes of acute phase cognitive therapy in outpatients with anxious versus nonanxious depression.
abstract: OBJECTIVE
  Compared to nonanxious depressed patients, anxious depressed patients respond less to pharmacotherapy, prompting consideration of alternate treatments. Based on the transdiagnostic principles of cognitive therapy (CT), we predicted that anxious depressed patients would respond as well to CT as nonanxious depressed patients.
  
  
  METHODS
  Adults (n = 523) with recurrent major depressive disorder received 12-14 weeks of CT as part of the Continuation Phase Cognitive Therapy Relapse Prevention Trial. Anxious depressed patients (n = 264; 50.4%) were compared to nonanxious depressed patients (n = 259; 49.6%) on demographic variables, initial severity, attrition, and rates and patterns of response and remission.
  
  
  RESULTS
  Anxious depressed patients presented with greater illness severity and had significantly lower response (55.3 vs. 68.3%) and remission rates (26.9 vs. 40.2%) based on clinician-administered measures. By contrast, smaller between-group differences for attrition, and for response (59.1 vs. 64.9%) and remission (41.7 vs. 48.7%) rates on self-report measures were not significant. Further, anxious depressed patients had greater speed of improvement on self-reported anxiety symptom severity and clinician-rated depressive and anxiety symptom severity measures.
  
  
  CONCLUSIONS
  Consistent with prior reports, anxious depressed patients presented with greater severity and, following CT, had lower response and remission rates on clinician-administered scales. However, anxious depressed patients improved more rapidly and response and remission rates on self-report measures were not significantly different from nonanxious depressed patients. Our findings suggest that anxious depressed patients may simply need additional time or more CT sessions to reach outcomes fully comparable to those of less anxious patients.
authors.affiliation: Department of Psychology, Southern Methodist University, Dedman College, PO Box 750442, Dallas, TX 75275, USA. jsmits@smu.edu
authors.forename: Jasper A J
authors.initials: JA
authors.lastname: Smits
authors.forename: Abu
authors.initials: A
authors.lastname: Minhajuddin
authors.forename: Michael E
authors.initials: ME
authors.lastname: Thase
authors.forename: Robin B
authors.initials: RB
authors.lastname: Jarrett
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D001008:Anxiety Disorders / Q000453:epidemiology; D015928:Cognitive Behavioral Therapy; D015897:Comorbidity; D003865:Major Depressive Disorder / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D010045:Outpatients / Q000523:psychology / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales; D012074:Remission Induction; D055502:Secondary Prevention; D057566:Self Report; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome