Temporal Course of Change of Depression

Department of Psychiatry and Behavioral Sciences, University of Oklahoma Health Sciences Center.
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 11/1993; 61(5):858-64. DOI: 10.1037/0022-006X.61.5.858
Source: PubMed


Two hundred fifty moderately to severely depressed outpatients were randomly assigned to 16 weeks of cognitive-behavioral therapy, interpersonal psychotherapy, imipramine plus clinical management (IMI-CM), or pill placebo plus clinical management. Two hundred thirty-nine patients actually began treatment. The most rapid change in depressive symptoms occurred in the IMI-CM condition, which achieved significantly better results than the other treatments at 8 and 12 weeks on 1 or more variables. Change over the course of treatment on variables hypothesized to be most specifically affected by the respective treatments was found only in the case of pharmacotherapy, in which imipramine produced significantly greater changes on the endogenous measure at 8 and 12 weeks.

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    • "In studies in which Cognitive Behavior Therapy (CBT) is contrasted with antidepressants, antidepressants sometimes achieve response rates faster, but by the end of the study outcomes equalize (Blackburn & Moore, 1997; Elkin et al., 1989; Shea et al., 1992; Simons, Murphy, Levine, & Wetzel, 1986; Watkins et al., 1993). A meta-analysis examining comparative efficacy of CBT versus drugs for the severely depressed found no difference in efficacy, although effect sizes were greater for the CBT group (DeRubeis, Gelfand, Tang, Simons, 1999). "
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    ABSTRACT: Questions regarding the efficacy of antidepressant drugs has been a recent focus of attention in the national news both in print and in the television media. Many clients will have questions regarding what they can believe and how they can address mood problems. Social workers constitute a greater percentage of the mental health work force than any other profession. Thus, social workers will probably be asked by clients about these issues. This paper presents information on the efficacy of antidepressants for both the short and long term. It covers adverse effects and withdrawal symptoms. Clients’ self-determination should be honored. However, social workers can be of assistance in supplying facts relevant to decision making.
    Social Work in Mental Health 11/2012; 10(6). DOI:10.1080/15332985.2012.699444
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    • "For example, a meta-analysis of a large sample of individuals (n = 2,431) pooled from numerous psychotherapy studies found that half of the patients studied achieved symptom relief within eight sessions of open-ended treatment (Howard et al. 1986). Conventional wisdom suggests that pharmacotherapy alleviates depressive symptoms more quickly than psychotherapy (Watkins et al. 1993). However, it is possible that patients and therapists work harder and faster when the number of psychotherapy sessions is limited from the outset (Reynolds et al. 1996), thereby hastening the onset of psychotherapy's antidepressant effects. "
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    ABSTRACT: Intervening with depressed women during their childbearing years, especially with those on low incomes, is critically important. Not only do mothers and expectant mothers suffer unnecessarily, but their untreated depression has critical negative consequences for their families. Despite this, these women have proven especially difficult to engage in psychotherapy. In this paper we describe several adaptations and additions we have made to a brief form of Interpersonal Psychotherapy (IPT) to meet the needs of mothers and expectant mothers living on low incomes in the community who suffer from depression, but face significant practical, psychological, and cultural barriers to engaging in and staying in treatment. In addition, we present some preliminary data on the extent to which our enhanced, brief IPT approach promotes improvements in treatment engagement and retention relative to usual care for expectant mothers on low incomes.
    Journal of Contemporary Psychotherapy 03/2008; 38(1):23-33. DOI:10.1007/s10879-007-9065-x
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    • "Another line of evidence is based on recognition of specific temporal courses of change during treatment of depression.96-99 Different types of treatment may affect the temporal course of change in depression,100 and the use of pattern analysis may differentiate true drug and placebo responses early in treatment.101 Patients do not suddenly become well, but tend to gradually lose their depressive symptoms over the months following treatment.102 "
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    ABSTRACT: There is a growing body of literature on residual symptoms after apparently successful treatment. The strong prognostic value of subthreshold symptomatology upon remission and the relationship between residual and prodromal symptomatology (the rollback phenomenon) have been outlined. Most residual symptoms also occur in the prodromal phase of depression and may progress to become prodromes of relapse. These findings entail important implications. It is necessary to closely monitor the patient throughout the different phases of illness and to assess the quality and extent of residual symptoms. A more stringent definition of recovery, which is not limited to symptomatic assessment, but includes psychological well-being, seems to be necessary. New therapeutic strategies for improving the level of remission, such as treatment of residual symptoms that progress to become prodromes of relapse and/or increasing psychological well-being, appear to yield more lasting benefits. The sequential model may provide room for innovative treatment approaches, including the use of drugs for specifically addressing residual symptoms. As occurs in other medical disorders (such as diabetes and hypertension), the active role of the patient in achieving recovery (self-therapy homework) should be pursued.
    Dialogues in clinical neuroscience 02/2008; 10(4):461-72.
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