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Antidepressant monotherapy vs sequential pharmacotherapy and mindfulness-based cognitive therapy, or placebo, for relapse prophylaxis in recurrent depression.

https://arctichealth.org/en/permalink/ahliterature138809
Source
Arch Gen Psychiatry. 2010 Dec;67(12):1256-64
Publication Type
Article
Date
Dec-2010
Author
Zindel V Segal
Peter Bieling
Trevor Young
Glenda MacQueen
Robert Cooke
Lawrence Martin
Richard Bloch
Robert D Levitan
Author Affiliation
Centre for Addiction and Mental Health, Toronto, ON, Canada. zindel_segal@camh.net
Source
Arch Gen Psychiatry. 2010 Dec;67(12):1256-64
Date
Dec-2010
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Antidepressive Agents - administration & dosage - therapeutic use
Attention
Cognitive Therapy - methods
Combined Modality Therapy - methods
Depressive Disorder, Major - drug therapy - prevention & control - psychology
Diagnostic and Statistical Manual of Mental Disorders
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Male
Middle Aged
Ontario
Outpatients - psychology
Psychiatric Status Rating Scales
Psychotherapy, Group - methods
Recurrence - prevention & control
Treatment Outcome
Young Adult
Abstract
Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse.
To compare rates of relapse in depressed patients in remission receiving MBCT against maintenance antidepressant pharmacotherapy, the current standard of care.
Patients who met remission criteria after 8 months of algorithm-informed antidepressant treatment were randomized to receive maintenance antidepressant medication, MBCT, or placebo and were followed up for 18 months.
Outpatient clinics at the Centre for Addiction and Mental Health, Toronto, Ontario, Canada, and St Joseph's Healthcare, Hamilton, Ontario.
One hundred sixty patients aged 18 to 65 years meeting DSM-IV criteria for major depressive disorder with a minimum of 2 past episodes. Of these, 84 achieved remission (52.5%) and were assigned to 1 of the 3 study conditions.
Patients in remission discontinued their antidepressants and attended 8 weekly group sessions of MBCT, continued taking their therapeutic dose of antidepressant medication, or discontinued active medication and were switched to placebo.
Relapse was defined as a return, for at least 2 weeks, of symptoms sufficient to meet the criteria for major depression on module A of the Structured Clinical Interview for DSM-IV.
Intention-to-treat analyses showed a significant interaction between the quality of acute-phase remission and subsequent prevention of relapse in randomized patients (P = .03). Among unstable remitters (1 or more Hamilton Rating Scale for Depression score >7 during remission), patients in both MBCT and maintenance treatment showed a 73% decrease in hazard compared with placebo (P = .03), whereas for stable remitters (all Hamilton Rating Scale for Depression scores =7 during remission) there were no group differences in survival.
For depressed patients achieving stable or unstable clinical remission, MBCT offers protection against relapse/recurrence on a par with that of maintenance antidepressant pharmacotherapy. Our data also highlight the importance of maintaining at least 1 long-term active treatment in unstable remitters.
Notes
Cites: Arch Gen Psychiatry. 2004 Jan;61(1):34-4114706942
Cites: Biol Psychiatry. 2003 Sep 1;54(5):573-8312946886
Cites: J Clin Psychiatry. 2004 Mar;65(3):328-3615096071
Cites: Arch Gen Psychiatry. 2004 Jul;61(7):669-8015237079
Cites: Am J Psychiatry. 2004 Oct;161(10):1872-615465985
Cites: Biometrics. 1983 Jun;39(2):499-5036354290
Cites: Arch Gen Psychiatry. 1987 Jun;44(6):540-83579500
Cites: Psychopharmacol Bull. 1987;23(2):309-243303100
Cites: Arch Gen Psychiatry. 1990 Dec;47(12):1093-92244793
Cites: Arch Gen Psychiatry. 1991 Sep;48(9):851-51929776
Cites: Am J Psychiatry. 1992 Aug;149(8):999-10101353322
Cites: J Clin Psychiatry. 1997;58 Suppl 7:37-409219493
Cites: Arch Gen Psychiatry. 1998 Sep;55(9):816-209736008
Cites: J Neurol Neurosurg Psychiatry. 1960 Feb;23:56-6214399272
Cites: J Clin Psychiatry. 2005 Mar;66(3):283-9015766292
Cites: J Clin Psychiatry. 2005 Nov;66(11):1392-40016420076
Cites: J Affect Disord. 2006 Mar;91(1):27-3216430968
Cites: Arch Gen Psychiatry. 2006 Jul;63(7):749-5516818864
Cites: J Clin Psychiatry. 2007 Aug;68(8):1246-5617854250
Cites: J Nerv Ment Dis. 2008 Aug;196(8):630-318974675
Cites: J Consult Clin Psychol. 2008 Dec;76(6):966-7819045965
Cites: Psychiatr Serv. 2009 Mar;60(3):337-4319252046
Cites: J Affect Disord. 2009 May;115(1-2):167-7018760488
Cites: BMJ. 2009;339:b356919776103
Cites: Psychol Med. 2010 Jan;40(1):41-5019460188
Cites: J Clin Psychiatry. 2010 Feb;71(2):121-919961809
Cites: Arch Gen Psychiatry. 2000 Apr;57(4):375-8010768699
Cites: Am J Psychiatry. 2000 Apr;157(4 Suppl):1-4510767867
Cites: J Psychopharmacol. 1998;12(3):305-1310958258
Cites: J Consult Clin Psychol. 2000 Aug;68(4):615-2310965637
Cites: Am J Psychiatry. 2000 Sep;157(9):1501-410964869
Cites: Arch Gen Psychiatry. 2001 Apr;58(4):381-811296099
Cites: Arch Gen Psychiatry. 2001 Apr;58(4):395-40111296101
Cites: J Affect Disord. 2001 Jul;65(2):155-6611356239
Cites: Arch Gen Psychiatry. 1999 Sep;56(9):829-3512884889
Cites: J Consult Clin Psychol. 2004 Feb;72(1):31-4014756612
PubMed ID
21135325 View in PubMed
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