Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T22:21:40.999Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive Behaviour Therapy and Depressive Relapse: Justified Optimism or Unwarranted Complacency?

Published online by Cambridge University Press:  16 June 2009

John W. Ludgate
John W. Ludgate
Affiliation:
Warneford Hospital, Oxford
Get access Rights & Permissions [Opens in a new window]

Abstract

The magnitude of the problem of relapse and recurrence in depression is outlined and it is contended that this is now the major treatment issue facing clinicians. Studies demonstrating a longer term prophylactic effect of Cognitive Behaviour Therapy (CBT) are briefly reviewed and it is concluded that these methods have significantly impacted on relapse rates in unipolar depression. Nevertheless, it is argued that there is little cause for complacency due to the still significant rate of relapse which is found with CBT. While promising cognitive behavioural methods have been developed in the field of addictive disorders, there is a clear need for similar clinical advances in the area of recurrent depression. Some strategies which may have potential for promoting maintenance and preventing relapse are briefly outlined. The importance of developing a coherent model for assessing relapse risk and guiding decisions regarding treatment and after care strategies is emphasized. Lastly, future research directions in this important area are briefly considered.

Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 22 , Issue 1 , January 1994 , pp. 1 - 11
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Baker, A.L. and Wilson, P.H. (1985). Cognitive-behavioural therapy for depression: the effect of booster sessions on relapse. Behavior Therapy 16, 335–344.CrossRefGoogle Scholar
Beck, A.T. (1967). Depression: Causes and Treatment. Philadelphia: University of Pennsylvania Press.Google Scholar
Beck, A.T. (1976). Cognitive Therapy and the Emotional Disorders. New York: International Universities Press.Google Scholar
Beck, A.T., Hollon, S.D., Young, J., Bedrosian, R.C. and Budenz, D. (1985). Treatment of depression with cognitive therapy and amitryptaline. Archives of General Psychiatry 42, 142–148.CrossRefGoogle Scholar
Beck, A.T., Sokol, L., Clark, D.A., Berchick, R. and Wright, F. (1992). A cross-over study of focused cognitive therapy for panic disorder. American Journal of Psychiatry 149, 778–783.Google ScholarPubMed
Beck, A.T., Rush, A.J., Shaw, B.F. and Emery, G. (1979). Cognitive Therapy for Depression. New York: Guilford Press.Google Scholar
Belsher, G. and Costello, C.G. (1988). Relapse after recovery from unipolar depression: a critical review. Psychological Bulletin 104, 84–96.CrossRefGoogle ScholarPubMed
Blackburn, I.M., Eunson, K.M. and Bishop, S. (1986). A two year naturalistic follow-up of depressed outpatients treated with cognitive therapy, pharmacotherapy and a combination of both. Journal of Affective Disorders 10, 67–75.CrossRefGoogle Scholar
Chiauzzi, E.J. (1992). Preventing Relapse in the Addictions: A Bio-psychosocial Approach. New York: Pergamon Press.Google Scholar
Clark, D.M., Salkovskis, P.M.G., Hackman, A. and Gelder, M. (1991). Long term outcome of cognitive therapy for panic disorder.Paper presented at the 25th Annual Meeting of the Association for the Advancement of Behavior Therapy.New York,November.Google Scholar
Evans, M.D., Hollon, S.D., DeRubeis, R.J., Piasecki, J., Grove, W.M., Garvey, M.J. and Tuason, V.B. (1992). Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry 49, 802–808.CrossRefGoogle ScholarPubMed
Frank, E. and Kupfer, D.J. (1985). Maintenance treatment of recurrent unipolar depression: pharmacology and psychotherapy. In Kemali, D. and Recagni, G. (Eds). Chronic Treatments in Neuropsychiatry. New York: Raven Press.Google Scholar
Frank, E. and Kupfer, D.J. (1989). Response to combined pharmacotherapy and psychotherapy among recurrent depressives. In Lerer, B. and Gershon, S. (Eds). New Directions in Affective Disorders. New York: Springer-Verlag.Google Scholar
Gonzales, L.R., Lewinsohn, P.M. and Clarke, G.N. (1985). A longitudinal follow-up of unipolar depressives: an investigation of predictors of relapse. Journal of Consulting and Clinical Psychology 53, 461–469.CrossRefGoogle ScholarPubMed
Greenwald, M.A. (1988). Programming treatment generalization. In Michelson, L. and Asher, M. (Eds). Handbook of Anxiety and Stress Disorders. New York: Plenum.Google Scholar
Hollon, S.D., Shelton, R.C. and Loosen, P.T. (1991). Cognitive therapy and pharmacotherapy for depression. Journal of Consulting and Clinical Psychology 59, 88–99.CrossRefGoogle ScholarPubMed
Jarrett, R.B. (1990). Cognitive therapy for depression: maintenance phase in unipolar major depressive disorder. Unpublished manual. University of Texas, South western Medical Center, Dallas, Texas.Google Scholar
Keller, M.B., Klerman, G.L., Lavori, P.W., Coryell, W., Endicott, J. and Taylor, J. (1984). Long term outcome of episodes of major depression. Journal of the American Medical Assocaiton 252, 788–792.CrossRefGoogle ScholarPubMed
Klerman, G.L. (1978). Long term maintenance of affective disorders. In Lipton, M., Dimascio, A. and Killam, K. (Eds). Psychopharmacology: A Generation of Progress. New York: Raven Press.Google Scholar
Klerman, G.L., Weissman, M.M., Rounsaville, B. and Chevron, E. (1984). Interpersonal Psychotherapy of Depression. New York: Basic Books.Google Scholar
Kovacs, M., Rush, A.J., Beck, A.T. and Hollen, S.D. (1981). Depressed outpatients treated with cognitive therapy or pharmacotherapy: a one year follow up. Archives of General Psychiatry 38, 33–39.CrossRefGoogle ScholarPubMed
Krantz, S.E., Hill, R.D., Foster-Rawlings, S. and Zeeve, C. (1984). Therapists' use of and perceptions of strategies for maintenance and generalization. The Cognitive Behaviorist 6, 19–22.Google Scholar
Kupfer, D.J. and Frank, E. (1987). Relapse in recurrent unipolar depression. Archives of General Psychiatry 144, 86–88.Google ScholarPubMed
Lewinsohn, P.M., Sullivan, J.M. and Grosscup, S.J. (1982). Behavioral therapy: clinical applications. In Rush, A.J. (Ed). Short-Term Psychotherapies for the Depressed Patient. New York: Guilford Press.Google Scholar
Ludgate, J.W. (1991). The long term effectiveness of cognitive therapy in the treatment of depression: a five-year follow up study of treated patients. Unpublished doctoral dissertation, University of Dublin, Ireland.Google Scholar
Ludgate, J.W. (1992). Relapse prevention groups for former cognitive therapy patients. International Cognitive Therapy Newsletter 6, 10–12.Google Scholar
Ludgate, J.W. (in press). Maximizing Psychotherapeutic Gains and Preventing Relapse with Emotionally Distressed Patients. Sarasota, Fl: Professional Resource Press.Google Scholar
Marlatt, A. and Gordon, J. (1985). Relapse Prevention. New York: Guilford Press.Google Scholar
Miller, I.W. (1984). Strategies for maintenance of treatment gains for depressed patients. The Cognitive Behaviorist 6, 10–13.Google Scholar
Miller, I.W., Norman, W.H. and Keitner, G.I. (1989). Cognitive-behavioral treatment of depressed inpatients: six and twelve month follow up. American Journal of Psychiatry 146, 1274–1279.Google ScholarPubMed
NIMH/NIH. Consensus Development Conference Statement (1985). Mood disorders: pharmacological prevention of recurrences. American Journal of Psychiatry 142, 469–475.Google Scholar
Scott, J. (1992). Chronic depression: can cognitive therapy succeed when other treatments fail? Behavioural Psychotherapy 20, 25–36.CrossRefGoogle Scholar
Shea, M.T., Elkin, I., Imber, S.D., Sotsky, S.M., Watkins, J.T., Collins, J.F., Pilkonis, P.A., Leber, W.R., Krupnick, J., Dolan, R.T. and Parloff, M.B. (1992). Course of depressive symptoms over follow-up: findings from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Archives of General Psychiatry 49, 782–787.CrossRefGoogle ScholarPubMed
Shiffman, S. (1989). Conceptual issues in the study of relapse. In Gossup, M. (Ed). Relapse and Addictive Behaviour. London: Tavistock/Routledge.Google Scholar
Shiffman, S. (1992). Relapse process and relapse prevention in the addictive behaviours. The Behavior Therapist 15, 9–11.Google Scholar
Simons, A.D., Murphy, G.E., Levine, J.L. and Wetzel, R.D. (1986). Cognitive therapy and pharmacotherapy of depression: sustained improvement over 1 year. Archives of General Psychiatry 43, 43–48.CrossRefGoogle Scholar
Teasdale, J.D. (1993). Emotion and two kinds of meaning: cognitive therapy and applied cognitive science. Behaviour Research and Therapy 31, 339–354.CrossRefGoogle ScholarPubMed
Thase, M.E. (1990). Relapse and recurrence in unipolar major depression: shortterm and long-term approaches. Journal of Clinical Psychiatry 51, 6 (suppl.), 51–57.Google ScholarPubMed
Thompson, L.W. and Gallagher, D. (1984). Efficacy of psychotherapy in the treatment of late life depression. Advances in Behaviour Research and Therapy 10, 127–139.CrossRefGoogle Scholar
Wilson, P.H. (Ed). (1992). Principles and Practice of Relapse Prevention. New York: Guilford Press.Google Scholar
Submit a response

Comments

No Comments have been published for this article.