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Long-term outcomes of acute treatment with cognitive therapy v. interpersonal psychotherapy for adult depression: follow-up of a randomized controlled trial

Published online by Cambridge University Press:  24 May 2018

Lotte H.J.M. Lemmens*
Affiliation:
Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
Suzanne C. van Bronswijk
Affiliation:
Department of Psychiatry and Psychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
Frenk Peeters
Affiliation:
Department of Psychiatry and Psychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands
Arnoud Arntz
Affiliation:
Department of Clinical Psychology, University of Amsterdam, PO Box 19268, 1000 GG Amsterdam, The Netherlands
Steven D. Hollon
Affiliation:
Department of Psychology, Vanderbilt University, 306 Wilson Hall, Nashville, Tennessee, USA
Marcus J.H. Huibers
Affiliation:
Department of Clinical Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands Department of Psychology, University of Pennsylvania, 3720 Walnut Street, Philadelphia, PA, 19104-6241, USA
*
Author for correspondence: Lotte Lemmens, E-mail: [email protected]

Abstract

Background

Although equally efficacious in the acute phase, it is not known how cognitive therapy (CT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) compare in the long run. This study examined the long-term outcomes of CT v. IPT for MDD.

Methods

One hundred thirty-four adult (18–65) depressed outpatients who were treated with CT (n = 69) or IPT (n = 65) in a large open-label randomized controlled trial (parallel group design; computer-generated block randomization) were monitored across a 17-month follow-up phase. Mixed regression was used to determine the course of self-reported depressive symptom severity (Beck Depression Inventory II; BDI-II) after treatment termination, and to test whether CT and IPT differed throughout the follow-up phase. Analyses were conducted for the total sample (n = 134) and for the subsample of treatment responders (n = 85). Furthermore, for treatment responders, rates of relapse and sustained response were examined for self-reported (BDI-II) and clinician-rated (Longitudinal Interval Follow-up Evaluation; LIFE) depression using Cox regression.

Results

On average, the symptom reduction achieved during the 7-month treatment phase was maintained across follow-up (7–24 months) for CT and IPT, both in the total sample and in the responder sample. Two-thirds (67%) of the treatment responders did not relapse across the follow-up period on the BDI-II. Relapse rates assessed with the LIFE were somewhat lower. No differential effects between conditions were found.

Conclusions

Patients who responded to IPT were no more likely to relapse following treatment termination than patients who responded to CT. Given that CT appears to have a prophylactic effect following successful treatment, our findings suggest that IPT might have a prophylactic effect as well.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2018 

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References

Barth, J, Munder, T, Gerger, H, Nuësch, E, Trelle, S, Znoj, H, Jüni, P and Cuijpers, P (2013) Comparative efficacy of seven psychotherapeutic interventions for patients with depression: a network meta-analysis. PLoS Medicine 10, e1001454.Google Scholar
Beck, AT, Steer, R and Brown, GK (1996) Beck Depression Inventory II: Manual. Boston: Hartcourt Brace.Google Scholar
Beck, AT, Rush, AJ, Shaw, BF and Emery, G (1979) Cognitive Therapy of Depression. New York: Guilford Press.Google Scholar
Burcusa, SL and Iacono, WG (2007) Risk for recurrence in depression. Clinical Psychology Review 27, 959985.Google Scholar
Cohen, J (1988) Statistical Power Analysis for the Behavioral Sciences. Hillsdale: Erlbaum.Google Scholar
Cox, DR and Oakes, D (1984) Analysis of Survival Data. London: Chapman & Hall.Google Scholar
Cuijpers, P, Andersson, G, Donker, T and Van Straten, A (2011) Psychological treatment of depression: results of a series of meta-analyses. Nordic Journal of Psychiatry 65, 354364.Google Scholar
Cuijpers, P, Berking, M, Andersson, G, Quigley, L, Kleiboer, A and Dobson, KS (2013 a) A meta-analysis of cognitive behavioural therapy for adult depression, alone and in comparison with other treatments. Canadian Journal of Psychiatry 58, 376385.Google Scholar
Cuijpers, P, Donker, T, Weissman, MM, Ravitz, P and Cristea, IA (2013 b) Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open 3, e002542.Google Scholar
Cuijpers, P, Hollon, SD, Van, Straten A, Bockting, C, Berking, M and Andersson, G (2013 c) The efficacy of psychotherapy and pharmacotherapy in treating depressive and anxiety disorders: a meta-analysis of direct comparisons. World Psychiatry 12, 137148.Google Scholar
Cuijpers, P, Sijbrandij, M, Koole, SL, Andersson, G, Beekman, AT and Reynolds, CF (2016) Interpersonal psychotherapy for mental health problems: a comprehensive meta-analysis. American Journal of Psychiatry 173, 680687.Google Scholar
De Graaf, LE, Gerhards, S, Evers, S, Arntz, A, Riper, H, Severens, J, Widdershoven, G, Metsemakers, J and Huibers, M (2008) Clinical and cost-effectiveness of computerised cognitive behavioural therapy for depression in primary care: design of a randomised trial. BMC Public Health 8, 224.Google Scholar
Derubeis, RJ, Cohen, ZD, Forand, NR, Fournier, JC, Gelfand, LA and Lorenzo-Luaces, L (2014) The personalized advantage index: translating research on prediction into individualized treatment recommendations. A demonstration. PLoS ONE 9, e83875.Google Scholar
Diggle, P, Heagerty, P, Liang, K and Zeger, S (2002) Analysis of Longitudinal Data. Oxford: Oxford University Press.Google Scholar
Dobson, KS, Shaw, BF and Vallis, TM (1985) Reliability of a measure of the quality of cognitive therapy. British Journal of Clinical Psychology 24, 295300.Google Scholar
Eaton, WW, Shao, H, Nestadt, G, Lee, HB, Bienvenu, OJ and Zandi, P (2008) Population-based study of first onset and chronicity in major depressive disorder. Archives of General Psychiatry 65, 513520.Google Scholar
Euroqol-Group (1990) EuroQol – a new facility for the measurement of health-related quality of life. Health Policy 16, 199208.Google Scholar
First, MB, Spitzer, RL, Gibbon, M and Williams, JBW (1997) Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). New York: Biometrics Research Department New York State Psychiatric Institute.Google Scholar
Hollon, SD, Derubeis, RJ, Shelton, RC, Amsterdam, JD, Salomon, RM, O'reardon, JP, Lovett, ML, Young, PR, Haman, KL, Freeman, BB and Gallop, R (1984) Systems for Rating Therapies for Depression. Los Angeles, CA: Annual Convention of the American Psychiatric Association.Google Scholar
Hollon, SD, Evans, MD, Auerbach, A, Derubeis, RJ, Elkin, I, Lowery, A, Kriss, M, Grove, W, Tuason, VB and Piasecki, J (1988) Development of a system for rating therapies for depression: differentiating cognitive therapy, interpersonal psychotherapy, and clinical management pharmacotherapy (unpublished manuscript).Google Scholar
Hollon, SD, Waskow, IE, Evans, M and Lowery, HA (2005) Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. Archives of General Psychiatry 62, 417422.Google Scholar
Huibers, MJH, Cohen, ZD, Lemmens, LHJM, Arntz, A, Peeters, FPML, Cuijpers, P and Derubeis, RJ (2015) Predicting optimal outcomes in cognitive therapy or interpersonal psychotherapy for depressed individuals using the personalized advantage index approach. PLoS ONE 10, e0140771.Google Scholar
Jacobson, NS and Truax, P (1991) Clinical significance: a statistical approach to define meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 59, 1219.Google Scholar
Jakobsen, JC, Hansen, JL, Simonsen, S, Simonsen, E and Gluud, C (2012) Effects of cognitive therapy versus interpersonal psychotherapy in patients with major depressive disorder: a systematic review of randomized clinical trials with meta-analyses and trial sequential analyses. Psychological Medicine 42, 13431357.Google Scholar
Keller, MB, Lavori, PW, Friedman, B, Nielsen, E, Endicott, J, Mcdonald-Scott, P and Andreasen, NC (1987) The longitudinal interval follow-up evaluation: a comprehensive method for assessing outcome in prospective longitudinal studies. Archives of General Psychiatry 44, 540548.Google Scholar
Klerman, GL, Weissman, MM, Rounsaville, BJ and Chevron, ES (1984) Interpersonal Psychotherapy for Depression. New York: Basis Books.Google Scholar
Lemmens, LHJM, Arntz, A, Peeters, FPML, Hollon, SD, Roefs, A and Huibers, MJH (2011) Effectiveness, relapse prevention and mechanisms of change of cognitive therapy vs. interpersonal therapy for depression: study protocol for a randomised controlled trial. Trials 12, 150162.Google Scholar
Lemmens, LHJM, Arntz, A, Peeters, FPML, Hollon, SD, Roefs, A and Huibers, MJH (2015) Clinical effectiveness of cognitive therapy vs. interpersonal psychotherapy for depression: results of a randomized controlled trial. Psychological Medicine 45, 20952110.Google Scholar
Lemmens, LHJM, Galindo-Garre, F, Arntz, A, Peeters, F, Hollon, SD, Derubeis, RJ and Huibers, MJH (2017) Exploring mechanisms of change in cognitive therapy and interpersonal psychotherapy for adult depression. Behaviour Research and Therapy 94, 8192.Google Scholar
Schafer, JL and Graham, JW (2002) Missing data: our view of the state of the art. Psychological Methods 7, 147177.Google Scholar
Shea, MT, Elkin, I, Imber, SD, Sotsky, SM, Watkins, JT, Collins, JF, Pilkonis, PA, Beckham, E, Glass, DR and Dolan, RT (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, 782787.Google Scholar
Singer, JD and Willett, JB (2003) Applied Longitudinal Data Analysis: Modeling Change and Event Occurrence. New York: Oxford University Press.Google Scholar
Snijders, TAB and Bosker, RJ (2012) Multilevel Analysis: An Introduction to Basic and Advanced Multilevel Modeling, 2nd Edn. London: Sage.Google Scholar
Solomon, DA, Keller, MB, Leon, AC and Al., E (2000) Multiple recurrences of major depressive disorder. American Journal of Psychiatry 157, 229233.Google Scholar
Stuart, S 2011. IPT Adherence and Quality Scale. Iowa: Interpersonal Psychotherapy Institute.Google Scholar
Van Der Does, W (2002) De Nederlandse Versie van de Beck Depression Inventory – Second Edition (BDI-II-NL). Enschede: Ipskamp.Google Scholar
Vittengl, JR, Clark, LA, Dunn, TW and Jarrett, RB (2007) Reducing relapse and recurrence in unipolar depression: a comparative meta-analysis of cognitive-behavioral therapy's effects. Journal of Consulting and Clinical Psychology 75, 457488.Google Scholar
Warshaw, MG, Keller, MB and Stout, RL (1994) Reliability and validity of the longitudinal interval follow-up evaluation for assessing outcome of anxiety disorders. Journal of Psychiatric Research 28, 531545.Google Scholar
Warshaw, MG, Dyck, I, Allsworth, J, Stout, RL and Keller, MB (2001) Maintaining reliability in a long-term psychiatric study: an ongoing inter-rater reliability monitoring program using the longitudinal interval follow-up evaluation. Journal of Psychiatric Research 35, 297305.Google Scholar
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