Abstract
Background Acute-phase cognitive therapy (CT) is an efficacious treatment for major depressive disorder (MDD), but responders experience varying post-acute outcomes (e.g., relapse vs. recovery). Responders’ symptom-change trajectories during response to acute-phase CT may predict longer term outcomes. Method We studied adult outpatients (N = 220) with recurrent MDD who responded to CT but had residual symptoms. Responders with linear (steady improvement), log-linear (quicker improvement earlier and slower later), one-step (a single, relatively large, stable improvement between adjacent assessments), or undefined (not linear, log-linear, or one-step) symptom trajectories were assessed every 4 months for 32 additional months. Results Defined (linear, log-linear, one-step) versus undefined acute-phase trajectories predicted lower depressive symptoms (d = 0.36), lower weekly probability of being in a major depressive episode (OR = 0.46), higher weekly probabilities of remission (OR = 1.93) and recovery (OR = 2.35), less hopelessness (d = 0.41), fewer dysfunctional attitudes (d = 0.31), and better social adjustment (d = 0.32) for 32 months after acute-phase CT. Differences among defined trajectory groups were nonsignificant. Conclusions Responding to acute-phase CT with a defined trajectory (orderly pattern) of symptom reduction predicts better longer term outcomes, but which defined trajectory (linear, log-linear, or one-step) appears unimportant. Frequent measurement of depressive symptoms to identify un/defined CT response trajectories may clarify need for continued clinical monitoring and treatment.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 48-57 |
| Number of pages | 10 |
| Journal | Behaviour Research and Therapy |
| Volume | 87 |
| DOIs | |
| State | Published - Dec 1 2016 |
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Keywords
- Cognitive therapy
- Major depressive disorder
- Recovery
- Relapse
- Trajectory
ASJC Scopus subject areas
- Experimental and Cognitive Psychology
- Developmental and Educational Psychology
- Arts and Humanities (miscellaneous)
- Clinical Psychology
- Psychiatry and Mental health
Cite this
Defined symptom-change trajectories during acute-phase cognitive therapy for depression predict better longitudinal outcomes. / Vittengl, Jeffrey R.; Clark, Lee Anna; Thase, Michael E.; Jarrett, Robin B.
In: Behaviour Research and Therapy, Vol. 87, 01.12.2016, p. 48-57.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Defined symptom-change trajectories during acute-phase cognitive therapy for depression predict better longitudinal outcomes
AU - Vittengl, Jeffrey R.
AU - Clark, Lee Anna
AU - Thase, Michael E.
AU - Jarrett, Robin B.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background Acute-phase cognitive therapy (CT) is an efficacious treatment for major depressive disorder (MDD), but responders experience varying post-acute outcomes (e.g., relapse vs. recovery). Responders’ symptom-change trajectories during response to acute-phase CT may predict longer term outcomes. Method We studied adult outpatients (N = 220) with recurrent MDD who responded to CT but had residual symptoms. Responders with linear (steady improvement), log-linear (quicker improvement earlier and slower later), one-step (a single, relatively large, stable improvement between adjacent assessments), or undefined (not linear, log-linear, or one-step) symptom trajectories were assessed every 4 months for 32 additional months. Results Defined (linear, log-linear, one-step) versus undefined acute-phase trajectories predicted lower depressive symptoms (d = 0.36), lower weekly probability of being in a major depressive episode (OR = 0.46), higher weekly probabilities of remission (OR = 1.93) and recovery (OR = 2.35), less hopelessness (d = 0.41), fewer dysfunctional attitudes (d = 0.31), and better social adjustment (d = 0.32) for 32 months after acute-phase CT. Differences among defined trajectory groups were nonsignificant. Conclusions Responding to acute-phase CT with a defined trajectory (orderly pattern) of symptom reduction predicts better longer term outcomes, but which defined trajectory (linear, log-linear, or one-step) appears unimportant. Frequent measurement of depressive symptoms to identify un/defined CT response trajectories may clarify need for continued clinical monitoring and treatment.
AB - Background Acute-phase cognitive therapy (CT) is an efficacious treatment for major depressive disorder (MDD), but responders experience varying post-acute outcomes (e.g., relapse vs. recovery). Responders’ symptom-change trajectories during response to acute-phase CT may predict longer term outcomes. Method We studied adult outpatients (N = 220) with recurrent MDD who responded to CT but had residual symptoms. Responders with linear (steady improvement), log-linear (quicker improvement earlier and slower later), one-step (a single, relatively large, stable improvement between adjacent assessments), or undefined (not linear, log-linear, or one-step) symptom trajectories were assessed every 4 months for 32 additional months. Results Defined (linear, log-linear, one-step) versus undefined acute-phase trajectories predicted lower depressive symptoms (d = 0.36), lower weekly probability of being in a major depressive episode (OR = 0.46), higher weekly probabilities of remission (OR = 1.93) and recovery (OR = 2.35), less hopelessness (d = 0.41), fewer dysfunctional attitudes (d = 0.31), and better social adjustment (d = 0.32) for 32 months after acute-phase CT. Differences among defined trajectory groups were nonsignificant. Conclusions Responding to acute-phase CT with a defined trajectory (orderly pattern) of symptom reduction predicts better longer term outcomes, but which defined trajectory (linear, log-linear, or one-step) appears unimportant. Frequent measurement of depressive symptoms to identify un/defined CT response trajectories may clarify need for continued clinical monitoring and treatment.
KW - Cognitive therapy
KW - Major depressive disorder
KW - Recovery
KW - Relapse
KW - Trajectory
UR - http://www.scopus.com/inward/record.url?scp=84984837759&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84984837759&partnerID=8YFLogxK
U2 - 10.1016/j.brat.2016.08.008
DO - 10.1016/j.brat.2016.08.008
M3 - Article
C2 - 27591917
AN - SCOPUS:84984837759
VL - 87
SP - 48
EP - 57
JO - Behaviour Research and Therapy
JF - Behaviour Research and Therapy
SN - 0005-7967
ER -