Predictors of longitudinal outcomes after unstable response to acute-phase cognitive therapy for major depressive disorder

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

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

After patients with major depressive disorder (MDD) respond to acute-phase cognitive therapy (CT), continuation-phase treatments may be applied to improve long-term outcomes. We clarified which CT responders experience remission, recovery, relapse, and recurrence by testing baseline demographic, clinical, and personality variables. The sample of CT responders at higher risk of relapse (N = 241) was randomized to 8 months of continuation-phase CT, double-blinded fluoxetine, or pill placebo, and followed 24 months (Jarrett & Thase, 2010). Patients with lower positive emotionality and behavioral activation at the end of acute-phase CT showed increased risk for relapse/recurrence of MDD. In addition, patients with lower positive emotionality and behavioral activation, as well as higher residual depression (including emotional, cognitive, and social facets), showed decreased probability of remission (≥6 continuous weeks of minimal or absent symptoms) after acute-phase CT. Finally, patients with greater residual depression, as well as younger age and earlier MDD onset, showed decreased probability of recovery (≥35 continuous weeks of minimal or absent symptoms) after acute-phase CT. Moderator analyses did not reveal differential prediction across the continuation phase treatment arms. These results may help clinicians gauge the prognoses and need for continuation treatment among MDD patients who respond to acute-phase CT.

Original languageEnglish (US)
Pages (from-to)268-277
Number of pages10
JournalPsychotherapy
Volume52
Issue number2
DOIs
StatePublished - Jun 1 2015

Keywords

  • Cognitive therapy
  • Depression
  • Fluoxetine
  • Moderator
  • Predictor

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Clinical Psychology

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