Cognitive behavioral treatment (CBT) of residual symptoms after successful pharmacotherapy yielded a substantially lower relapse rate than did clinical management in patients with primary major depressive disorders.
The aim of this study was to test the effectiveness of this approach in patients with recurrent depression (=3 episodes of depression).
Forty patients with recurrent major depression who had been successfully treated with antidepressant drugs were randomly assigned to either CBT of residual symptoms (supplemented by lifestyle modification and well-being therapy) or clinical management.
In both groups, during the 20-week experiment, antidepressant drug administration was tapered and discontinued.
Residual symptoms were measured with a modified version of the Paykel Clinical Interview for Depression.
Two-year follow-up was undertaken, during which no antidepressant drugs were used unless a relapse ensued.
The CBT group had a significantly lower level of residual symptoms after discontinuation of drug therapy compared with the clinical management group.
At 2-year follow-up, CBT also resulted in a lower relapse rate (25%) than did clinical management (80%). This difference attained statistical significance by survival analysis.
These results challenge the assumption that long-term drug treatment is the only tool to prevent relapse in patients with recurrent depression. (...)
Mots-clés Pascal : Etat dépressif, Efficacité traitement, Prévention, Récidive, Thérapie cognitive, Thérapie comportementale, Santé mentale, Homme, Trouble humeur
Mots-clés Pascal anglais : Depression, Treatment efficiency, Prevention, Relapse, Cognitive therapy, Behavior therapy, Mental health, Human, Mood disorder
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0449341
Code Inist : 002B18I06. Création : 25/01/1999.