Effects up to 20-Year Follow-Up of Preventive Cognitive Therapy in Adults Remitted from Recurrent Depression: The DELTA Study.

IF 16.3 1区医学 Q1 PSYCHIATRY

Psychotherapy and Psychosomatics Pub Date : 2023-01-01 DOI:10.1159/000527906

Amanda M Legemaat, Huibert Burger, Gert J Geurtsen, Marlies Brouwer, Philip Spinhoven, Damiaan Denys, Claudi L Bockting

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引用次数: 2

Abstract

Introduction: Major depressive disorder (MDD) is common, and recurrence rates are high. Preventive Cognitive Therapy (PCT), has been shown to prolong time to recurrence and reduce risk of recurrence(s) over 2-10 years in patients with recurrent depression.

Objective: The aim of the study was to examine the effectiveness of PCT over 20 years on time to first recurrence, cumulative proportion of first recurrences, percentage of depression-free time, mean severity of recurrences, and the number of recurrences within a patient.

Methods: Adults remitted from recurrent MDD were randomized to PCT or Treatment As Usual (TAU). Clinical outcomes were assessed using the SCID over 20 years. We used Cox regression analyses, Kaplan-Meier analyses, ANOVA, and negative binomial regression and tested for interaction with the number of previous episodes.

Results: There was a significant interaction effect for number of previous episodes with treatment condition on time to first recurrence (Wald[1, n = 172] = 8.840, p = 0.003). For participants with more than 3 previous episodes, the mean time to recurrence was 4.8 years for PCT versus 1.6 years for TAU; the cumulative proportion of first recurrences was 87.5% for PCT and 100% for TAU. For participants with more than 3 previous episodes, exploratory analyses suggest that PCT had 53% less recurrences and percentage of depression-free time was significantly higher compared to TAU. There were no significant effects on mean severity.

Conclusions: Up to 20 years, for MDD patients with more than 3 previous episodes, those who received PCT had significantly longer time to a first recurrence and lower recurrence risk and may have less recurrences and more depression-free time compared to TAU. This suggests long term protective effects of PCT up to 20-years.

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预防认知疗法对成人复发性抑郁症患者长达20年的随访效果:DELTA研究。

重度抑郁障碍(MDD)是一种常见的疾病，复发率高。预防性认知疗法(PCT)已被证明可以延长复发时间，并降低复发风险(s)超过2-10年的复发性抑郁症患者。目的:本研究的目的是检查PCT在20年内首次复发的时间、首次复发的累积比例、无抑郁时间的百分比、平均复发严重程度和患者复发次数的有效性。方法:复发性重度抑郁症的成年人被随机分配到PCT或常规治疗(TAU)组。临床结果评估使用SCID超过20年。我们使用了Cox回归分析、Kaplan-Meier分析、方差分析和负二项回归，并测试了与既往发作次数的相互作用。结果:既往发作次数与治疗条件、首次复发时间存在显著交互作用(Wald[1, n = 172] = 8.840, p = 0.003)。对于既往发作超过3次的参与者，PCT的平均复发时间为4.8年，TAU为1.6年;PCT首次复发的累计比例为87.5%，TAU为100%。对于既往发作超过3次的参与者，探索性分析表明，与TAU相比，PCT的复发率降低了53%，无抑郁时间的百分比显著高于TAU。对平均严重程度没有显著影响。结论:在长达20年的时间里，对于既往发作超过3次的MDD患者，与TAU相比，接受PCT的患者首次复发的时间明显更长，复发风险更低，复发率更低，无抑郁时间更长。这表明PCT具有长达20年的长期保护作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Psychotherapy and Psychosomatics 医学-精神病学

CiteScore

29.40

自引率

6.10%

发文量

期刊介绍： Psychotherapy and Psychosomatics is a reputable journal that has been published since 1953. Over the years, it has gained recognition for its independence, originality, and methodological rigor. The journal has been at the forefront of research in psychosomatic medicine, psychotherapy research, and psychopharmacology, and has contributed to the development of new lines of research in these areas. It is now ranked among the world's most cited journals in the field. As the official journal of the International College of Psychosomatic Medicine and the World Federation for Psychotherapy, Psychotherapy and Psychosomatics serves as a platform for discussing current and controversial issues and showcasing innovations in assessment and treatment. It offers a unique forum for cutting-edge thinking at the intersection of medical and behavioral sciences, catering to both practicing clinicians and researchers. The journal is indexed in various databases and platforms such as PubMed, MEDLINE, Web of Science, Science Citation Index, Social Sciences Citation Index, Science Citation Index Expanded, BIOSIS Previews, Google Scholar, Academic Search, and Health Research Premium Collection, among others.