Article

Randomized Trial of Behavioral Activation, Cognitive Therapy, and Antidepressant Medication in the Prevention of Relapse and Recurrence in Major Depression

Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 07/2008; 76(3):468-77. DOI: 10.1037/0022-006X.76.3.468
Source: PubMed

ABSTRACT

This study followed treatment responders from a randomized controlled trial of adults with major depression. Patients treated with medication but withdrawn onto pill-placebo had more relapse through 1 year of follow-up compared to patients who received prior behavioral activation, prior cognitive therapy, or continued medication. Prior psychotherapy was also superior to medication withdrawal in the prevention of recurrence across the 2nd year of follow-up. Specific comparisons indicated that patients previously exposed to cognitive therapy were significantly less likely to relapse following treatment termination than patients withdrawn from medication, and patients previously exposed to behavioral activation did almost as well relative to patients withdrawn from medication, although the difference was not significantly different. Differences between behavioral activation and cognitive therapy were small in magnitude and not significantly different across the full 2-year follow-up, and each therapy was at least as efficacious as the continuation of medication. These findings suggest that behavioral activation may be nearly as enduring as cognitive therapy and that both psychotherapies are less expensive and longer lasting alternatives to medication in the treatment of depression.

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    • "A large clinical trial demonstrated comparable effects of BA to pharmacotherapy (paroxetine) and superior effects to cognitive therapy, particularly among more severely depressed patients (Dimidjian et al., 2006). Follow-up work showed BA may also prevent relapse better than pharmacotherapy over the long-term (Dobson et al., 2008). Efforts are in place to translate this BA approach for adolescents (McCauley et al., 2011; Ritschel & Craighead, 2011) while incorporating key adaptations, including, flexible sequencing and duration of components, greater parental involvement, and attention to suicidal risk. "
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    • "Distintos paradigmas han ofrecido explicaciones sobre la depresión, como la teoría de la desesperanza (abramson, seligman y teasdale, 1978) o los estilos de respuesta (NolenHoeksema, 1991), entre otros. No obstante, la propuesta de Beck es especialmente relevante debido al sustento empírico del que goza, proporcionado por la eficacia comprobada de las intervenciones clínicas basadas en sus supuestos teóricos, dirigidas tanto a población clínica como general, así como a adultos y adolescentes (Butler, chapman, Forman y Beck, 2006;clark y Beck, 2010;Derubeis et al., 2005;Dobson et al. 2008;lakdawalla, Hankin y Mermelstein, 2007). De acuerdo con Beck (1967), la depresión se caracteriza por tristeza, apatía, concepto negativo de sí mismo, autorreproches , culpa, conductas de evitación, síntomas somáticos y cambios en el nivel de actividad física. "

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