Deterioration in psychosocial functioning predicts relapse/recurrence after cognitive therapy for depression

Area of Science:

• Psychiatry
• Clinical Psychology
• Mental Health Research

Background:

• The relationship between major depressive disorder (MDD) and psychosocial functioning during treatment, particularly continuation phase cognitive therapy (C-CT), requires further clarification.
• The Range of Impaired Functioning Tool (RIFT) was assessed for its validity in measuring psychosocial functioning and its association with depressive symptoms.

Purpose of the Study:

• To evaluate the RIFT as a valid measure of psychosocial functioning in patients with recurrent MDD.
• To examine the relationship between psychosocial functioning and depressive symptoms during C-CT and an assessment-only control condition.

Main Methods:

• Outpatients with recurrent MDD who responded to acute-phase cognitive therapy (A-CT) were randomized to 8 months of C-CT or assessment-only.
• Participants were followed for an additional 16 months, with monthly assessments of depressive symptoms and psychosocial functioning via interviews and self-reports.

Main Results:

• The RIFT demonstrated appropriate convergence with other measures of psychosocial functioning, depressive symptoms, cognitive content, and personality.
• Approximately 55% of patients achieved psychosocial wellness (RIFT ≤ 8) within the first month post-A-CT.
• While C-CT offered only transient improvements in psychosocial functioning compared to controls, psychosocial dysfunction predicted subsequent depressive symptom changes and relapse/recurrence.

Conclusions:

• The RIFT is a valid instrument for assessing psychosocial functioning in depression responders.
• Deteriorations in psychosocial functioning following acute treatment may serve as early indicators of impending major depressive relapse or recurrence.
• These findings suggest that targeting psychosocial dysfunction could be a valuable strategy in relapse prevention treatments for depression.