Prevention of relapse following cognitive therapy vs medications in moderate to severe depression.
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of Pennsylvania and Vanderbilt University who responded to cognitive therapy in a randomized, controlled trial were withdrawn from treatment and compared to medication responders during a 12-month post-treatment period.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.
The study found that patients withdrawn from CT were significantly less likely to relapse during continuation than patients withdrawn from medications (30.8% vs 76.2%; P = .004), and no more likely to relapse than patients who kept taking continuation medication (30.8% vs 47.2%; P = .20).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.
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
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