Treatments for depression vary widely. Some individuals with depression receive therapeutic interventions such as cognitive behavioral therapy (CBT), mindfulness therapy, or other psychosocial treatments. Others are prescribed pharmacological remedies such as antidepressants. Some people with depression receive both therapy and medication.
Although both methods have been shown to be effective at treating acute depression and decreasing symptoms in the short-term, it is unclear which method works best at providing long-term protection from depression relapse. Therefore, Pim Cuijpers of the Department of Psychology at the VU University Amsterdam in the Netherlands wanted to compare the enduring effects of both treatments.
Using nine studies involving over 500 participants, Cuijpers analyzed data on short-term efficacy of CBT and medication for acute depression by seeing which worked better when administered only for a brief period of time. Then Cuijpers compared the long-term effects of both. Finally, data was assessed to determine if acute CBT that was continued during a 12-month period was better at preventing relapse than acute medication that was discontinued.
The results revealed that there were significant differences in relapse rates depending on treatment type. “Patients who received acute phase CBT were significantly less likely to relapse than patients who were withdrawn from pharmacotherapy,” said Cuijpers. Further, although there were no large differences in relapse between acute CBT and continued medication treatment, the participants who received brief CBT had slightly lower rates of relapse than those who continued medication without CBT.
This suggests that CBT and other psychosocial interventions provide long-lasting protection from relapse via behavior and emotional changes. Specifically, these techniques empower individuals with awareness, knowledge, and tools they need to address emotional challenges in the future. Rather than reverting to prior thought processes, people at risk for depression can use these new skills to overcome negative thinking and negative mood states. In sum, these findings suggest that although long-term therapy may be the best prevention against relapse, even short-term therapy administered during the acute phase of depression may provide long-lasting protection from relapse.
Cuijpers, P., Hollon, S.D., van Straten, A., et al. (2013). Does cognitive behavior therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open 2013;3:e002542. doi:10.1136/bmjopen-2012-002542
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