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Is there a role for continuation phase cognitive therapy for depressed outpatients?
R B Jarrett1, M R Basco, R Risser
1Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas 75235-9149, USA. rjarr1@mednet.swmed.edu
Journal of Consulting and Clinical Psychology
|January 6, 1999
Summary
Continuation phase cognitive therapy (C-CT) may reduce major depressive disorder relapse. Study 2, using C-CT, showed lower relapse rates than Study 1, which did not use C-CT.
Area of Science:
- Psychiatry
- Clinical Psychology
Background:
- Major depressive disorder (MDD) relapse is a significant clinical concern.
- Cognitive therapy (CT) is an effective acute treatment for MDD.
Purpose of the Study:
- To evaluate the efficacy of continuation phase CT (C-CT) in preventing MDD relapse or recurrence.
- To compare relapse rates between patients receiving acute CT only versus those receiving acute and continuation CT.
Main Methods:
- Two pilot studies with sequential cohorts of MDD outpatients who responded to acute CT (A-CT).
- Study 1: Monthly, treatment-free follow-up. Study 2: 8 months (10 sessions) of C-CT followed by monthly follow-up.
- Kaplan-Meier and log-rank tests were used to estimate and compare relapse/recurrence rates.
Main Results:
- Study 1 showed cumulative relapse/recurrence rates of 50% at 12 months and 74% at 24 months.
- Study 2 demonstrated significantly lower cumulative relapse/recurrence rates: 27% at 12 months and 36% at 24 months.
- An exploratory log-rank test indicated superior relapse-free survival in Study 2 compared to Study 1.
Conclusions:
- Continuation phase CT (C-CT) may be effective in reducing the rate of relapse or recurrence in major depressive disorder.
- These findings, if replicated, suggest C-CT as a valuable strategy for long-term MDD management.
- Further research is warranted to confirm these results and explore alternative explanations.