Hostname: page-component-586b7cd67f-2plfb Total loading time: 0 Render date: 2024-11-23T23:02:06.103Z Has data issue: false hasContentIssue false
  • English
  • Français

Controlled acute and follow-up trial of cognitive therapy and pharmacotherapy in out-patients with recurrent depression

Published online by Cambridge University Press:  03 January 2018

I.-M. Blackburn  and
R. G. Moore
I.-M. Blackburn*
Affiliation:
Newcastle Cognitive and Behavioural Therapies Centre
R. G. Moore
Affiliation:
Department of Psychiatry, University of Cambridge, Addenbrooke's Hospital (Box 189), Hills Road, Cambridge CB2 2QQ
*
Professor I.-M. Blackburn, Newcastle Cognitive and Behavioural Therapies Centre, Collingwood Clinic, St Nicholas Hospital, Gosforth, Newcastle upon Tyne NE3 3XT
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

We report a randomised controlled trial, in both the acute and maintenance stage of treatment, in 75 outpatients with recurrent major depression.

Method

Patients were allocated to three groups: 16 weeks of acute treatment and two years' maintenance treatment in the following way: antidepressants and maintenance antidepressants; cognitive therapy and maintenance cognitive therapy: antidepressants and maintenance cognitive therapy. Both completers' and end-point data were analysed.

Results

In the acute phase of treatment, all patients improved significantly and there was no significant difference among treatments, or in the pattern of improvement over time. In the maintenance stage of treatment, patients kept improving over time in all three groups and there was no significant difference among treatments. Cognitive therapy was consistently superior to medication.

Conclusions

The results indicate that maintenance cognitive therapy has a similar prophylactic effect to maintenance medication and is a viable option for maintenance after acute treatment with medication in recurrent depression.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 4 , October 1997 , pp. 328 - 334
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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

Beck, A. T., Ward, C. H., Mendelson, M., et al (1961) An inventory for measuring depression. Archives of General Psychiatry. 4, 561–571.CrossRefGoogle ScholarPubMed
Beck, A. T., Rush, A. J., Shaw, B. F., et al (1979) Cognitive Therapy of Depression. New York: Guilford Google Scholar
Blackburn, I.-M., Eunson, K. M. & Bishop, S. (1986) A two-year naturalistic follow-up of depressed patients treated with cognitive therapy, pharmacotherapy and a combination of both. Journal of Affective Disorders. 10, 67–75.CrossRefGoogle Scholar
Blackburn, I.-M., & Twaddle, V. (1996) Cognitive Therapy in Action. A Practitioner's Casebook. London: Souvenir Press.Google Scholar
Carney, M. W. P., Roth, M. & Garslde, R. F. (1965) The diagnosis of depressive syndromes and the prediction of ECT response. British Journal of Psychiatry, III, 659–674.Google Scholar
Elkin, I., Shee, M. T., Watldns, J. T., et al (1989) National Institute of Mental Health Treatment of Depression Collaborative Research Program. General effectiveness of treatments. Archives of General Psychiatry, 44, 971–982.Google Scholar
Elkin, I., Shee, M. T., Watldns, J. T., et al (1995) Initial severity and differential treatment outcome in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology, 43, 841–847.Google Scholar
Endicott, J., Spitzer, R. L., Fleiss, J. Z., et al (1976) The Global Assessment Scale: a procedure measuring overall severity of psychiatric disturbance. Archives of General Psychiatry, 33, 766–771.Google Scholar
Endicott, J., & Spitzer, R. L., (1978) A diagnostic interview: The schedule for affective disorders and schizophrenia. Archives of General Psychiatry, 35, 837–844.CrossRefGoogle ScholarPubMed
Evans, M. D., Hollon, S. D., DeRubeis, R. J., et al (1992) Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry, 49, 802–808.Google Scholar
Frank, E., Kupfer, D. J., Perel, J. M., et al (1990) Three-year outcome for maintenance therapies in recurrent depression. Archives of General Psychiatry, 47, 1093–1099.CrossRefGoogle ScholarPubMed
Georgotas, A., McCue, R. E. & Coppar, T. B. (1989) A placebo-controlled comparison of nostriptyline and phenelzine in maintenance therapy of elderly depressed patients. Archives of General Psychiatry, 44, 783–786.Google Scholar
Glen, A. I. M., Johnson, A. L. & Shepherd, M. (1984) Continuation therapy with lithium and amitriptyline in unipolar depressive illness: a randomized, double blind, controlled trial. Psychological Medicine. 14, 37–50.CrossRefGoogle ScholarPubMed
Greenhouse, J. B., Stangl, D., Kupfer, D. J., et al (1991) Methodologic issues in maintenance therapy clinical trials. Archives of General Psychiatry, 48, 313–318.Google Scholar
Hamilton, M. A. (1960) A rating scale for depression. Journal of Neurology, Neurosurgery and Psychiatry, 23, 56–62.Google Scholar
Hollon, S. D., DeRubeis, R. J., Evans, M. D., et al (1992) Cognitive therapy and pharmacotherapy for depression singly and in combination. Archives of General Psychiatry, 49, 774–781.CrossRefGoogle ScholarPubMed
Kaller, M. B., Lavori, P. B., Klerman, G. L., et al (1986) The persistent risk of chronicity in recurrent episodes of non bipolar major depressive disorder. A prospective follow-up. American Journal of Psychiatry, 143, 24–28.Google Scholar
McDonald, R. M. (1991) Assessment of organizational context: A missing component in evaluations of training programs. Evaluation and Program Planning. 14, 273–277.Google Scholar
McLesn, P. D. & Taylor, S. (1992) Severity of unipolar depression and choice of treatment. Behaviour Research and Therapy. 30, 443–451.CrossRefGoogle Scholar
Prusoff, B. A., Klerman, G. L. & Paykal, E. S. (1972) Concordance between clinical assessments and patients' self-report in depression. Archives of General Psychiatry 24, 546–552.CrossRefGoogle Scholar
Rush, A. J., Beck, A. T., Kovacs, M., et al (1977) Comparative efficiency of cognitive therapy versus pharmacotherapy in outpatient depression. Cognitive Therapy and Research, 1, 17–37.CrossRefGoogle Scholar
Shea, M. T., Elkin, I., Imber, S. D., et al (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.Google Scholar
Simons, A. D., Murphy, G. E., Levine, J. L., et al (1986) Cognitive therapy and pharmacotherapy for depression: sustained improvement over one year. Archives of General Psychiatry, 43, 43–48.Google Scholar
Spitzer, R. L., Endicott, J. & Robins, E. (1978) Research diagnostic criteria: Rationale and reliability. Archives of General Psychiatry, 35, 773–782.CrossRefGoogle ScholarPubMed
Thase, M. E. (1992) Long-term treatments of recurrent depressive disorders. Journal of Clinical Psychiatry, 53 (suppl.). 32–44.Google Scholar
Thase, M. E. Simons, A. D., Cahalane, J., et al (1991) Severity of depression and response to cognitive behavior therapy. American Journal of Psychiatry, 148, 784–789.Google Scholar
Thase, M. E. Simons, A. D., McGeary, J., et al (1992) Relapse after cognitive behavior therapy of depression: potential implications for longer courses of treatment. American Journal of Psychiatry, 149, 1046–1052.Google ScholarPubMed
Submit a response

eLetters

No eLetters have been published for this article.