Reducing relapse in depressed outpatients with atypical features: A pilot study

Robin B. Jarrett, Dolores Kraft, Martin Schaffer, Amy Witt-Browder, Richard Risser, Deborah H. Atkins, Jeanette Doyle

Research output: Contribution to journalArticle

36 Citations (Scopus)

Abstract

Background: Patients with major depressive disorder (MDD) and atypical features have reactive mood plus at least two sympoms: hypersomnia, hyperphagia, leaden paralysis or a lifetime sensitivity to rejection. These patients respond to cognitive therapy (CT) or phenelzine (PHZ) significantly more than pill placebo (PBO). The purpose of this report is to motivate research on tolerable continuation phase treatment designed to reduce the significant risk of relapse and recurrence which depressed patients with atypical features face. Methods: Outpatients with DSM-III-R MDD and atypical features who responded to acute-phase CT, clinical management plus PHZ or PBO (n = 31) were randomized to continue or discontinue treatment for 8 months and participate in 16 months or treatment-free follow-up. Results: A log-rank test showed that the relapse and recurrence-free survival over the 24 months after the acute phase was significantly greater for the responders who continued treatment than for those who discontinued treatment. Kaplan-Meier estimates of relapse and recurrence were significantly higher for patients whose treatment was discontinued than for those whose treatment continued (83 vs 49% based on unblinded ratings of the Research Diagnostic Criteria for MDD or of self/other referral for treatment of depressive symptoms). Conclusions: We note several important limitations of the design and analysis of these pilot data. We hypothesize that not only pharmacotherapy, but also CT used as a continuation phase treatment may reduce relapse in this population. This hypothesis warrants rigorous evaluation in samples of outpatients with MDD and atypical features that are large enough to allow comparative tests. Copyright (C) 2000 S. Karger AG, Basel.

Original languageEnglish (US)
Pages (from-to)232-239
Number of pages8
JournalPsychotherapy and Psychosomatics
Volume69
Issue number5
StatePublished - Sep 2000

Fingerprint

Outpatients
Recurrence
Major Depressive Disorder
Cognitive Therapy
Phenelzine
Therapeutics
Placebos
Disorders of Excessive Somnolence
Hyperphagia
Kaplan-Meier Estimate
Research
Paralysis
Diagnostic and Statistical Manual of Mental Disorders
Referral and Consultation
Depression
Drug Therapy
Survival
Population

Keywords

  • Atypical depression
  • Cognitive therapy
  • Phenelzine
  • Randomized clinical trial
  • Relapse prevention

ASJC Scopus subject areas

  • Psychology(all)

Cite this

Jarrett, R. B., Kraft, D., Schaffer, M., Witt-Browder, A., Risser, R., Atkins, D. H., & Doyle, J. (2000). Reducing relapse in depressed outpatients with atypical features: A pilot study. Psychotherapy and Psychosomatics, 69(5), 232-239.

Reducing relapse in depressed outpatients with atypical features : A pilot study. / Jarrett, Robin B.; Kraft, Dolores; Schaffer, Martin; Witt-Browder, Amy; Risser, Richard; Atkins, Deborah H.; Doyle, Jeanette.

In: Psychotherapy and Psychosomatics, Vol. 69, No. 5, 09.2000, p. 232-239.

Research output: Contribution to journalArticle

Jarrett, RB, Kraft, D, Schaffer, M, Witt-Browder, A, Risser, R, Atkins, DH & Doyle, J 2000, 'Reducing relapse in depressed outpatients with atypical features: A pilot study', Psychotherapy and Psychosomatics, vol. 69, no. 5, pp. 232-239.
Jarrett RB, Kraft D, Schaffer M, Witt-Browder A, Risser R, Atkins DH et al. Reducing relapse in depressed outpatients with atypical features: A pilot study. Psychotherapy and Psychosomatics. 2000 Sep;69(5):232-239.
Jarrett, Robin B. ; Kraft, Dolores ; Schaffer, Martin ; Witt-Browder, Amy ; Risser, Richard ; Atkins, Deborah H. ; Doyle, Jeanette. / Reducing relapse in depressed outpatients with atypical features : A pilot study. In: Psychotherapy and Psychosomatics. 2000 ; Vol. 69, No. 5. pp. 232-239.
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