title: The predictive value of early response in patients with depressive disorders.
abstract: Several randomized controlled trials have identified early response to psychotherapy as a predictor for later treatment outcome among patients with depressive disorders. However, supporting evidence under routine conditions is rare. This study evaluated the predictive value of early improvement for final outcomes in psychotherapy among depressive patients in the naturalistic setting of a German university outpatient clinic.
  
  
  
  We used the method of percent symptom reduction to classify 639 patients with major depression or dysthymic disorder who underwent an average of 40.0 sessions (SD = 16.3) of naturalistic cognitive-behavioral therapy (CBT) as having either an early response or an early nonresponse.
  
  
  
  Early response was a good predictor for final response and remission regarding depressive symptoms (OR = 8.75 and OR = 5.32, respectively), as well as overall psychological distress (OR = 3.95 and OR = 3.16, respectively). Early nonresponse was distinctly associated with later deterioration of both depressive (OR = 9.56) and general psychological symptomatology (OR = 4.92).
  
  
  
  Early response to psychotherapy has high predictive qualities for positive later treatment outcome in depressive patients under routine CBT. Therefore, early treatment effects should be considered in clinical decision-making and treatment planning in everyday clinical practice.
authors.affiliation: a Department of Psychology , University of Mainz , Mainz , Germany.
authors.forename: Henrike Stephanie
authors.initials: HS
authors.lastname: Schlagert
authors.affiliation: a Department of Psychology , University of Mainz , Mainz , Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Hiller
mesh_terms: D000328:Adult; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000628:therapy*; D019263:Dysthymic Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D013997:Time Factors
keywords: cognitive-behavioral therapy; depression; early response; naturalistic psychotherapy research; outcome prediction; routine psychotherapies