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15-01-2022 | Original Article

Initial Severity and Depressive Relapse in Cognitive Behavioral Therapy and Antidepressant Medications: An Individual Patient Data Meta-analysis

Auteurs: Jay C. Fournier, Nicholas R. Forand, Zheng Wang, Zhexuan Li, Satish Iyengar, Robert J. DeRubeis, Richard Shelton, Jay Amsterdam, Robin B. Jarrett, Jeffrey R. Vittengl, Zindel Segal, Sona Dimidjian, M. Tracie Shea, Keith S. Dobson, Steven D. Hollon

Gepubliceerd in: Cognitive Therapy and Research | Uitgave 3/2022

Abstract

Background

Baseline severity has emerged as a key predictor of acute response to treatments for depression. The goals of this individual patient data meta-analysis were to compare the relapse prevention effects of acute phase cognitive behavioral therapy (CBT) vs. acute phase antidepressant medications (ADM) either continued (-c) or discontinued (-d) and determine whether baseline depression severity moderated these effects.

Methods

We included all available relevant randomized trials of CBT versus ADM in adult outpatients with depression. Cox proportional hazards models were used to examine whether treatment condition, baseline severity, and additional characteristics were associated with relapse.

Results

Using individual participant data from 5 of 10 published trials (N = 341), CBT (HR = 0.38, 95% CI 0.26–0.57) and ADM-c (HR = 0.48, 95% CI 0.29–0.80) were superior to ADM-d in preventing relapse over 12 months but did not differ from each other (HR = 1.26, 95% CI 0.76–2.09). Baseline severity did not moderate these effects.

Conclusions

Regardless of a patient’s baseline symptom severity, CBT and ADM-c both prevent depressive relapse substantially better than medication discontinuation. Given the shorter duration of treatment and equivalent longer-term outcomes, treatment with CBT might be considered a first choice for adults with depression.

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It has become conventional to distinguish “relapse,” defined as the return of symptoms following remission, from “recurrence,” defined as a new episode following recovery (Frank, et al., 1991) But, the validity of precise criteria for differentiating between relapse and recurrence has not been well established, and it can be difficult in practice to determine when an individual has “recovered” from an index episode. Because we are interested in the effect of severity on symptom return at any point following the end of acute treatment, we do not make distinctions between relapse and recurrence in our analyses, using “relapse” as a universal term for the return of depressive symptoms following acute phase treatment.

Due to the expected small number of RCT’s comparing CBT to medications, the inclusion criteria were intentionally broad. For example, eight sessions is a relatively short and non-standard treatment length and a follow-up of only 6 months is relatively brief. All identified trials had longer durations of acute treatment (10–24 weeks) and longer follow-up (8 to 18 months) than the minimum criteria. Also, the inclusion criteria allowed no more than 5 booster sessions, however, of the included trials only one offered booster sessions and the maximum number offered was 3 (Hollon et al., 2005). There is a small inconsistency in the original registration between the inclusion criteria, which indicates that anyone receiving ADM who is then followed will be included, and the “comparison condition”, which mentions only those who received ADM acutely and were later withdrawn onto placebo. Given the small number of studies and given that our intention was to capture as many trials as possible, we use the stated inclusion criteria throughout and consider for the ADM-d group anyone who was withdrawn from ADM during follow-up.

We use the term “follow-up” to refer to the phase of each study that took place immediately following acute treatment. Some of the studies used other terms to label this phase, e.g., “continuation phase.” Three of the studies (Dobson et al., 2008; Hollon et al., 2005; Jarrett et al., 2000) terminated all continuation treatments at the end of this phase and continued to follow participants naturalistically for another year or more. Those data were not included in the current report as the arms of the naturalistic portions of those studies no longer matched the arms in the “follow-up” phase.

The non-significant difference between CBT and ADM-c represented a small effect (NNT = 16) and power to detect a difference of this magnitude was low in this sample. Conservatively, total samples of > 1800 would be needed to detect an effect of this magnitude given the observed overall relapse rates (SAS PROC POWER; Hsieh & Lavori, 2000).

Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. The Guilford Press.

Beshai, S., Dobson, K. S., Bockting, C. L. H., & Quigley, L. (2011). Relapse and recurrence prevention in depression: Current research and future prospects. Clinical Psychology Review, 31, 1349–1360.PubMedCrossRef

Blackburn, I., Eunson, K., & 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.PubMedCrossRef

Bockting, C. L. H., Hollon, S. D., Jarrett, R. B., Kuyken, W., & Dobson, K. (2015). A lifetime approach to major depressive disorder: The contributions of psychological interventions in preventing relapse and recurrence. Clinical Psychology Review, 41, 16–26.PubMedCrossRef

Buckman, J. E. J., Underwood, A., Clarke, K., Saunders, R., Hollon, S. D., Fearon, P., & Pilling, S. (2018). Risk factors for relapse and recurrence of depression in adults and how they operate: A four-phase systematic review and meta-synthesis. Clinical Psychology Review, 64, 13–38.PubMedCrossRef

Cipriani, A., Furukawa, T. A., Salanti, G., Chaimani, A., Atkinson, L. Z., Ogawa, Y., Leucht, S., Ruhé, H. G., Turner, E. H., Higgins, J. P. T., Egger, M., Takeshima, N., Hayasaka, Y., Imai, H., Shinohara, K., Tajika, A., Ioannidis, J. P. A., & Geddes, J. R. (2018). Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: A systematic review and network meta-analysis. The Lancet, 391, 1357–1366.CrossRef

Cuijpers, P., Berking, M., Andersson, G., Quigley, L., Kleiboer, A., & Dobson, K. S. (2013). A meta-analysis of cognitive–behavioural therapy for adult depression, alone and in comparison with other treatments. Canadian Journal of Psychiatry, 58, 376–385.PubMedCrossRef

Cuijpers, P., Hollon, S. D., van Straten, A., Bockting, C., Berking, M., & Andersson, G. (2013b). Does cognitive behaviour therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. British Medical Journal Open, 3, e002542.

Cuijpers, P., van Straten, A., Warmerdam, L., & Andersson, G. (2008). Psychological treatment of depression: A meta-analytic database of randomized studies. BMC Psychiatry, 8, 36.PubMedPubMedCentralCrossRef

David, D., Szentagotai, A., Lupu, V., & Cosman, D. (2008). Rational emotive behavior therapy, cognitive therapy, and medication in the treatment of major depressive disorder: A randomized clinical trial, posttreatment outcomes, and six-month follow-up. Journal of Clinical Psychology, 64, 728–746.PubMedCrossRef

Davies, J., & Read, J. (2019). A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addictive Behaviors, 97, 111–121.PubMedCrossRef

DeRubeis, R. J., Gelfand, L. A., Tang, T. Z., & Simons, A. D. (1999). Medications versus cognitive behavior therapy for severely depressed outpatients: Mega-analysis of four randomized comparisons. American Journal of Psychiatry, 156, 1007–1013.PubMed

DeRubeis, R. J., Hollon, S. D., Amsterdam, J. D., Shelton, R. C., Young, P. R., Salomon, R. M., O’Reardon, J. P., Lovett, M. L., Gladis, M. M., Brown, L. L., & Gallop, R. (2005). Cognitive therapy vs medications in the treatment of moderate to severe depression. Archives of General Psychiatry, 62, 409–416.PubMedCrossRef

Dobson, K. S., Hollon, S. D., Dimidjian, S., Schmaling, K. B., Kohlenberg, R. J., Gallop, R. J., Rizvi, S. L., Gollan, J. K., Dunner, D. L., & Jacobson, N. S. (2008). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the prevention of relapse and recurrence in major depression. Journal of Consulting and Clinical Psychology, 76, 468–477.PubMedPubMedCentralCrossRef

Driessen, E., Cuijpers, P., Hollon, S. D., & Dekker, J. J. M. (2010). Does pretreatment severity moderate the efficacy of psychological treatment of adult outpatient depression? A meta-analysis. Journal of Consulting and Clinical Psychology, 78, 668–680.PubMedCrossRef

Evans, M. D., Hollon, S. D., DeRubeis, R. J., Piasecki, J. M., &, et al. (1992). Differential relapse following cognitive therapy and pharmacotherapy for depression. Archives of General Psychiatry, 49, 802–808.PubMedCrossRef

Fava, G. A., & Cosci, F. (2019). Understanding and managing withdrawal syndromes after discontinuation of antidepressant drugs. Journal of Clinical Psychiatry, 80, 19com12794.PubMed

Fournier, J. C., DeRubeis, R. J., Hollon, S. D., Dimidjian, S., Amsterdam, J. D., Shelton, R. C., & Fawcett, J. (2010). Antidepressant drug effects and depression severity: A patient-level meta-analysis. JAMA, 303, 47–53.PubMedPubMedCentralCrossRef

Fournier, J. C., DeRubeis, R. J., Shelton, R. C., Gallop, R., Amsterdam, J. D., & Hollon, S. D. (2008). Antidepressant medications vs. cognitive therapy in people with depression with or without personality disorder. British Journal of Psychiatry, 192, 124–129.CrossRef

Fournier, J. C., DeRubeis, R. J., Shelton, R. C., Hollon, S. D., Amsterdam, J. D., & Gallop, R. (2009). Prediction of response to medication and cognitive therapy in the treatment of moderate to severe depression. Journal of Consulting and Clinical Psychology, 77, 775–787.PubMedPubMedCentralCrossRef

Frank, E., Prien, R. F., Jarrett, R. B., Keller, M. B., Kupfer, D. J., Lavori, P. W., Rush, A. J., & Weissman, M. M. (1991). Conceptualization and rationale for consensus definitions of terms in major depressive disorder: Remission, recovery, relapse, and recurrence. Archives of General Psychiatry, 48, 851.PubMedCrossRef

Gartlehner, G., Gaynes, B. N., Amick, H. R., Asher, G. N., Morgan, L. C., Coker-Schwimmer, E., Forneris, C., Boland, E., Lux, L. J., Gaylord, S., Bann, C., Pierl, C. B., & Lohr, K. N. (2016). Comparative benefits and harms of antidepressant, psychological, complementary, and exercise treatments for major depression: An evidence report for a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 164, 331–341.PubMedCrossRef

Gopinath, S., Katon, W. J., Russo, J. E., & Ludman, E. J. (2007). Clinical factors associated with relapse in primary care patients with chronic or recurrent depression. Journal of Affective Disorders, 101, 57–63.PubMedCrossRef

Hardeveld, F., Spijker, J., De Graaf, R., Nolen, W. A., & Beekman, A. T. F. (2010). Prevalence and predictors of recurrence of major depressive disorder in the adult population. Acta Psychiatrica Scandinavica, 122, 184–191.PubMedCrossRef

Higgins, J. P. T., Altman, D. G., Gøtzsche, P. C., Jüni, P., Moher, D., Oxman, A. D., Savovic, J., Schulz, K. F., Weeks, L., Sterne, J. A. C., Cochrane Bias Methods Group, & Cochrane Statistical Methods Group. (2011). The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ, 343, d5928.PubMedPubMedCentralCrossRef

Hollon, S. D., DeRubeis, R. J., Shelton, R. C., Amsterdam, J. D., Salomon, R. M., O’Reardon, J. P., Lovett, M. L., Young, P. R., Haman, K. L., Freeman, B. B., & Gallop, R. (2005). Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. Archives of General Psychiatry, 62, 417–422.PubMedCrossRef

Hsieh, F. Y., & Lavori, P. W. (2000). Sample-size calculations for the Cox proportional hazards regression model with nonbinary covariates. Controlled Clinical Trials, 21, 552–560.PubMedCrossRef

Ilardi, S. S., Craighead, W. E., & Evans, D. D. (1997). Modeling relapse in unipolar depression: The effects of dysfunctional cognitions and personality disorders. Journal of Consulting and Clinical Psychology, 65, 381–391.PubMedCrossRef

Jarrett, R. B., Kraft, D., Doyle, J., Foster, B. M., Eaves, G. G., & Silver, P. C. (2001). Preventing recurrent depression using cognitive therapy with and without a continuation phase: A randomized clinical trial. Archives of General Psychiatry, 58, 381–388.PubMedPubMedCentralCrossRef

Jarrett, R. B., Kraft, D., Schaffer, M., Witt-Browder, A., Risser, R., Atkins, D. H., & Doyle, J. (2000). Reducing relapse in depressed outpatients with atypical features: A pilot study. Psychotherapy and Psychosomatics, 69, 232–239.PubMedCrossRef

Jarrett, R. B., Minhajuddin, A., Gershenfeld, H., Friedman, E. S., & Thase, M. E. (2013). Preventing depressive relapse and recurrence in higher-risk cognitive therapy responders: A randomized trial of continuation phase cognitive therapy, fluoxetine, or matched pill placebo. JAMA Psychiatry, 70, 1152.PubMedPubMedCentralCrossRef

Jarrett, R. B., Minhajuddin, A., Vittengl, J. R., Clark, L. A., & Thase, M. E. (2016). Quantifying and qualifying the preventive effects of acute-phase cognitive therapy: Pathways to personalizing care. Journal of Consulting and Clinical Psychology, 84, 365–376.PubMedCrossRef

Jong, V. M. T., Moons, K. G. M., Riley, R. D., Tudur Smith, C., Marson, A. G., Eijkemans, M. J. C., & Debray, T. P. A. (2020). Individual participant data meta-analysis of intervention studies with time-to-event outcomes: A review of the methodology and an applied example. Research Synthesis Methods, 11, 148–168.PubMedPubMedCentralCrossRef

Katon, W. J., Fan, M.-Y., Lin, E. H. B., & Unützer, J. (2006). Depressive symptom deterioration in a large primary care-based elderly cohort. The American Journal of Geriatric Psychiatry, 14, 246–254.PubMedCrossRef

Katsahian, S., Latouche, A., Mary, J.-Y., Chevret, S., & Porcher, R. (2008). Practical methodology of meta-analysis of individual patient data using a survival outcome. Contemporary Clinical Trials, 29, 220–230.PubMedCrossRef

Keller, M. B., Lavori, P. W., Lewis, C. E., & Klerman, G. L. (1983). Predictors of relapse in major depressive disorder. JAMA, 250, 3299–3304.PubMedCrossRef

Kennedy, J. C., Dunlop, B. W., Craighead, L. W., Nemeroff, C. B., Mayberg, H. S., & Craighead, W. E. (2018). Follow-up of monotherapy remitters in the PReDICT study: Maintenance treatment outcomes and clinical predictors of recurrence. Journal of Consulting and Clinical Psychology, 86, 189–199.PubMedPubMedCentralCrossRef

Kennedy, N., Abbott, R., & Paykel, E. S. (2003). Remission and recurrence of depression in the maintenance era: Long-term outcome in a Cambridge cohort. Psychological Medicine, 33, 827–838.PubMedCrossRef

Khan, A., Leventhal, R. M., Khan, S. R., & Brown, W. A. (2002). Severity of depression and response to antidepressants and placebo: An analysis of the Food and Drug Administration database. Journal of Clinical Psychopharmacology, 22, 40–45.PubMedCrossRef

Kirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008). Initial severity and antidepressant benefits: A meta-analysis of data submitted to the Food and Drug Administration. PLoS Medicine, 5, e45.PubMedPubMedCentralCrossRef

Klein, D. F. (1996). Preventing hung juries about therapy studies. Journal of Consulting and Clinical Psychology, 64, 81–87.PubMedCrossRef

Kovacs, M., Rush, A. J., Beck, A. T., & Hollon, S. D. (1981). Depressed outpatients treated with cognitive therapy or pharmacotherapy. A one-year follow-up. Archives of General Psychiatry, 38, 33–39.PubMedCrossRef

Langan, D., Higgins, J. P. T., Jackson, D., Bowden, J., Veroniki, A. A., Kontopantelis, E., Viechtbauer, W., & Simmonds, M. (2018). A comparison of heterogeneity variance estimators in simulated random-effects meta-analyses. Research Synthesis Methods, 10, 83–98.PubMedCrossRef

McGrath, P. J., Stewart, J. W., Quitkin, F. M., Chen, Y., Alpert, J. E., Nierenberg, A. A., Fava, M., Cheng, J., & Petkova, E. (2006). Predictors of relapse in a prospective study of fluoxetine treatment of major depression. American Journal of Psychiatry, 163, 1542–1548.PubMedCrossRef

McHugh, R. K., Whitton, S. W., Peckham, A. D., Welge, J. A., & Otto, M. W. (2013). Patient preference for psychological vs pharmacologic treatment of psychiatric disorders: A meta-analytic review. The Journal of Clinical Psychiatry, 74, 595–602.PubMedPubMedCentralCrossRef

Melartin, T. K., Rytsala, H. J., Leskela, U. S., Lestela-Mielonen, P. S., Sokero, T. P., & Isometsa, E. T. (2004). Severity and comorbidity predict episode duration and recurrence of DSM-IV major depressive disorder. Journal of Clinical Psychiatry, 65, 810–819.PubMedCrossRef

Mueller, T. I., Leon, A. C., Keller, M. B., Solomon, D. A., Endicott, J., Coryell, W., Warshaw, M., & Maser, J. D. (1999). Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. The American Journal of Psychiatry, 156, 1000–1006.PubMed

Nierenberg, A. A., Husain, M. M., Trivedi, M. H., Fava, M., Warden, D., Wisniewski, S. R., Miyahara, S., & Rush, A. J. (2010). Residual symptoms after remission of major depressive disorder with citalopram and risk of relapse: A STAR*D report. Psychological Medicine, 40, 41–50.PubMedCrossRef

O’Leary, D., Hickey, T., Lagendijk, M., & Webb, M. (2010). Onset of remission and relapse in depression: Testing operational criteria through course description in a second Dublin cohort of first-admission participants. Journal of Affective Disorders, 125, 221–226.PubMedCrossRef

Ramana, R., Paykel, E. S., Cooper, Z., Hayhurst, H., Saxty, M., & Surtees, P. G. (1995). Remission and relapse in major depression: A two-year prospective follow-up study. Psychological Medicine, 25, 1161–1170.PubMedCrossRef

Riley, R. D., Lambert, P. C., & Abo-Zaid, G. (2010). Meta-analysis of individual participant data: Rationale, conduct, and reporting. BMJ, 340, c221.PubMedCrossRef

Rucci, P., Frank, E., Calugi, S., Miniati, M., Benvenuti, A., Wallace, M., Fagiolini, A., Maggi, L., Kupfer, D. J., & Cassano, G. B. (2011). Incidence and predictors of relapse during continuation treatment of major depression with SSRI, interpersonal psychotherapy, or their combination. Depression and Anxiety, 28, 955–962.PubMedCrossRef

Segal, Z. V., Kennedy, S., Gemar, M., Hood, K., Pedersen, R., & Buis, T. (2006). Cognitive reactivity to sad mood provocation and the prediction of depressive relapse. Archives of General Psychiatry, 63, 749–755.PubMedCrossRef

Shea, M. T., Elkin, I., Imber, S. D., Sotsky, S. M., Watkins, J. T., Collins, J. F., Pilkonis, P. A., Beckham, E., Glass, D. R., Dolan, R. T., & Parloff, M. B. (1992). Course of depressive symptoms over follow-up: Findings from the NIMH Treatment of Depression Collaborative Research Program. Archives of General Psychiatry, 49, 782–787.PubMedCrossRef

Simons, A. D., Murphy, G. E., Levine, J. L., & Wetzel, R. D. (1986). Cognitive therapy and pharmacotherapy for depression. Sustained improvement over one year. Archives of General Psychiatry, 43, 43–48.PubMedCrossRef

Smith, C. T., Williamson, P. R., & Marson, A. G. (2005). Investigating heterogeneity in an individual patient data meta-analysis of time to event outcomes. Statistics in Medicine, 24, 1307–1319.PubMedCrossRef

Taylor, D. J., Walters, H. M., Vittengl, J. R., Krebaum, S., & Jarrett, R. B. (2010). Which depressive symptoms remain after response to cognitive therapy of depression and predict relapse and recurrence? Journal of Affective Disorders, 123, 181–187.PubMedCrossRef

ten Doesschate, M. C., Bockting, C. L. H., Koeter, M. W. J., Schene, A. H., & Delta Study Group. (2010). Prediction of recurrence in recurrent depression: A 5.5-year prospective study. Journal of Clinical Psychiatry, 71, 984–991.PubMedCrossRef

Therneau, T. M. (2020). coxme: Mixed effects cox models. R package version 2.2-16.

Tierney, J. F., Vale, C., Riley, R., Smith, C. T., Stewart, L., Clarke, M., & Rovers, M. (2015). Individual participant data (IPD) meta-analyses of randomised controlled trials: Guidance on their use. PLoS Medicine, 12, e1001855.PubMedPubMedCentralCrossRef

Vittengl, J. R., Jarrett, R. B., Weitz, E., Twisk, J., Cristea, I., David, D., DeRubeis, R. J., Dimidjian, S., Dunlop, B. W., Faramarzi, M., Hegerl, U., Kennedy, S. H., Kheirkhah, F., Mergl, R., Miranda, J., Mohr, D. C., Rush, A. J., Segal, Z. V., Siddique, J., … Cuijpers, P. (2016). Divergent outcomes in cognitive behavioral therapy and pharmacotherapy for adult depression. American Journal of Psychiatry, 173, 481–490.PubMedCrossRef

Weitz, E. S., Hollon, S. D., Twisk, J., van Straten, A., Huibers, M. J. H., David, D., DeRubeis, R. J., Dimidjian, S., Dunlop, B. W., Cristea, I. A., Faramarzi, M., Hegerl, U., Jarrett, R. B., Kheirkhah, F., Kennedy, S. H., Mergl, R., Miranda, J., Mohr, D. C., Rush, A. J., … Cuijpers, P. (2015). Baseline depression severity as moderator of depression outcomes between cognitive behavioral therapy vs pharmacotherapy. JAMA Psychiatry, 72, 1102–1108.PubMedCrossRef

Yang, H., Chuzi, S., Sinicropi-Yao, L., Johnson, D., Chen, Y., Clain, A., Baer, L., McGrath, P. J., Stewart, J. W., Fava, M., & Papakostas, G. I. (2010). Type of residual symptom and risk of relapse during the continuation/maintenance phase treatment of major depressive disorder with the selective serotonin reuptake inhibitor fluoxetine. European Archives of Psychiatry and Clinical Neuroscience, 260, 145–150.PubMedCrossRef

Titel: Initial Severity and Depressive Relapse in Cognitive Behavioral Therapy and Antidepressant Medications: An Individual Patient Data Meta-analysis
Auteurs: Jay C. Fournier
Nicholas R. Forand
Zheng Wang
Zhexuan Li
Satish Iyengar
Robert J. DeRubeis
Richard Shelton
Jay Amsterdam
Robin B. Jarrett
Jeffrey R. Vittengl
Zindel Segal
Sona Dimidjian
M. Tracie Shea
Keith S. Dobson
Steven D. Hollon
Publicatiedatum: 15-01-2022
Uitgeverij: Springer US
Gepubliceerd in: Cognitive Therapy and Research / Uitgave 3/2022
Print ISSN: 0147-5916
Elektronisch ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-021-10281-x

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Abstract

Background

Methods

Results

Conclusions

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