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Improved cognitive content endures for 2 years among unstable responders to acute-phase cognitive therapy for recurrent major depressive disorder.
Vittengl, J R; Clark, L A; Thase, M E; Jarrett, R B.
Afiliación
  • Vittengl JR; Department of Psychology,Truman State University,Kirksville,MO,USA.
  • Clark LA; Department of Psychology,University of Notre Dame,Notre Dame,IN,USA.
  • Thase ME; Department of Psychiatry,Perelman School of Medicine,University of Pennsylvania,Philadelphia,PA,USA.
  • Jarrett RB; Department of Psychiatry,The University of Texas Southwestern Medical Center,Dallas,TX,USA.
Psychol Med ; 45(15): 3191-204, 2015 Nov.
Article en En | MEDLINE | ID: mdl-26098793
BACKGROUND: The cognitive model of depression suggests that cognitive therapy (CT) improves major depressive disorder (MDD) in part by changing depressive cognitive content (e.g. dysfunctional attitudes, hopelessness). The current analyses clarified: (1) the durability of improvements in cognitive content made by acute-phase CT responders; (2) whether continuation-phase CT (C-CT) or fluoxetine (FLX) further improves cognitive content; and (3) the extent to which cognitive content mediates continuation treatments' effects on depressive symptoms and major depressive relapse/recurrence. METHOD: Out-patients with recurrent MDD who responded to acute-phase CT (n = 241) were randomized to 8 months of C-CT, FLX or pill placebo (PBO) and followed for an 24 additional months. Cognitive content was assessed approximately every 4 months using five standard patient-report measures. RESULTS: Large improvements in cognitive content made during acute-phase CT were maintained for 32 months, with 78-90% of patients scoring in normal ranges, on average. Cognitive content varied little between C-CT, FLX and PBO arms, overall. Small, transient improvements in cognitive content in C-CT or FLX compared with PBO patients did not clearly mediate the treatments' effects on depressive symptoms or on major depressive relapse/recurrence. CONCLUSIONS: Outpatients with recurrent MDD who respond to acute-phase CT show durable improvements in cognitive content. C-CT or FLX may not continue to improve patient-reported cognitive content substantively, and thus may treat recurrent MDD by other paths.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pensamiento / Terapia Cognitivo-Conductual / Fluoxetina / Evaluación de Resultado en la Atención de Salud / Inhibidores Selectivos de la Recaptación de Serotonina / Trastorno Depresivo Mayor Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Psychol Med Año: 2015 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Pensamiento / Terapia Cognitivo-Conductual / Fluoxetina / Evaluación de Resultado en la Atención de Salud / Inhibidores Selectivos de la Recaptación de Serotonina / Trastorno Depresivo Mayor Tipo de estudio: Clinical_trials / Observational_studies / Prognostic_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Psychol Med Año: 2015 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Reino Unido