Could Treatment Matching Patients’ Beliefs About Depression Improve Outcomes?

Jeffrey R. Vittengl, Lee Anna Clark, Michael E. Thase, Robin B. Jarrett

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Patients’ beliefs about depression and expectations for treatment can influence outcomes of major depressive disorder (MDD) treatments. We hypothesized that patients with weaker biological beliefs (less endorsement of [a] biochemical causes and [b] need for medication) and more optimistic treatment expectations (greater improvement and shorter time to improvement), have better outcomes in cognitive therapy (CT). Outpatients with recurrent MDD who received acute-phase CT (N = 152), and a subset of partial or unstable responders (N = 51) randomized to 8 months of continuation CT or fluoxetine with clinical management, completed repeated measures of beliefs, expectations, and depression. As hypothesized, patients with weaker biological beliefs about depression, and patients who expected a shorter time to improvement, experienced greater change in depressive symptoms and more frequent response to acute-phase CT. Moreover, responders who received continuation treatment better matched to their biological beliefs (i.e., responders with weaker biological beliefs about depression who received continuation CT, or responders with stronger biological beliefs about depression who received continuation fluoxetine) had fewer depressive symptoms and less relapse/recurrence by 32 months after acute-phase CT than did responders who received mismatched continuation treatment. Specific screening and/or intervention targeting patients’ biological beliefs about depression could increase CT efficacy.

Original languageEnglish (US)
Pages (from-to)765-777
Number of pages13
JournalBehavior Therapy
Volume50
Issue number4
DOIs
StatePublished - Jul 2019

Keywords

  • beliefs
  • cognitive therapy
  • depression
  • expectations
  • relapse

ASJC Scopus subject areas

  • Clinical Psychology

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