Long-Term Effects of Preventive Cognitive Therapy in Recurrent Depression: A 5.5-Year Follow-Up Study
J Clin Psychiatry 2009;70(12):1621-1628
© Copyright 2014 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Objective: Major depressive disorder (MDD) was projected to rank second on a list of 15 major diseases in terms of burden in 2030. A crucial part of the treatment of depression is the prevention of relapse/recurrence in high-risk groups, ie, recurrently depressed patients. The long-term preventive effects of group cognitive therapy (CT) in preventing relapse/recurrence in recurrent depression are not known. This article reports on the long-term (5.5-year) outcome of a randomized controlled trial to prevent relapse/recurrence in patients with recurrent depression. We specifically evaluated the long-term effects of CT in relation to the number of previous episodes experienced.
Method: From February through September 2000, patients with recurrent depression (DSM-IV–diagnosed) who were in remission (N = 172) were recruited from primary and specialty care facilities. They were randomly assigned to treatment as usual (TAU) versus TAU augmented with brief group CT. The primary outcome measure was time to relapse/recurrence, which was assessed over 5.5 years.
Results: Over 5.5 years, augmenting TAU with CT resulted in a significant protective effect (P = .003), which intensified with the number of previous depressive episodes experienced. For
patients with 4 or more previous episodes (52%
of the sample), CT significantly reduced cumulative relapse/recurrence from 95% to 75% (medium effect size).
Conclusions: Our findings indicate that brief CT, started after remission from a depressive episode on diverse types of treatment in patients with multiple prior episodes, has long-term preventive effects for at least 5.5 years. Implementation of brief relapse prevention CT should be considered in the continued care of patients with recurrent depression.
Trial Registration: ccmo-online.nl Identifier: NTR454
Submitted: October 7, 2008; accepted January 2, 2009.
Corresponding author: Claudi L. H. Bockting, PhD, Faculty of Social
and Behavioral Sciences, Department of Clinical Psychology, University
of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, The Netherlands (email@example.com).