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Prevention of relapse following cognitive therapy vs medications in moderate to severe depression.

25 Apr
Researchers from the Department of Psychology, Vanderbilt University, investigated whether cognitive therapy (CT) has an enduring effect in preventing the return of depressive symptoms, and compared this to the effect produced by continued antidepressant medication.

One hundred four patients (57.8% of those initially assigned) with moderate to severe depression, from outpatient clinics at the University of Pennsylvania and Vanderbilt University who responded to cognitive therapy in a randomized, controlled trial were withdrawn from treatment and compared to medication responders during a 12-month post-treatment period. These subjects were randomly assigned to either continuation medication or placebo withdrawal. Patients were allowed no more than 3 booster sessions during continuation; patients assigned to continuation medication were kept at full dosage levels.
Relapse was defined as a return, for at least 2 weeks, of symptoms sufficient to meet the criteria for major depression or Hamilton Depression Rating Scale scores of 14 or higher. Recurrence was defined in a comparable fashion during the subsequent naturalistic follow-up.

The study found that patients withdrawn from CT were significantly less likely to relapse during continuation than patients withdrawn from medications (30.8% vs 76.2%; P = .004), and no more likely to relapse than patients who kept taking continuation medication (30.8% vs 47.2%; P = .20). There were also indications that the effect of CT extends to the prevention of recurrence. Researchers conclude that cognitive therapy has an enduring effect that extends beyond the end of treatment, and seems to be as effective as keeping patients on medication.

Citation: Hollon SD, DeRubeis RJ, Shelton RC, Amsterdam JD, Salomon RM, O''Reardon JP, Lovett ML, Young PR, Haman KL, Freeman BB, Gallop R. Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. Archives of General Psychiatry. 2005 Apr; 62 (4): pages 417-22. This email address is being protected from spambots. You need JavaScript enabled to view it.
Belleruth Naparstek

Psychotherapist, author and guided imagery pioneer Belleruth Naparstek is the creator of the popular Health Journeys guided imagery audio series. Her latest book on imagery and posttraumatic stress, Invisible Heroes: Survivors of Trauma and How They Heal (Bantam Dell), won the Spirituality & Health Top 50 Books Award