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Depression: HELP
Articles by Steven D. Hollon
Based on 85 articles published since 2010
(Why 85 articles?)
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Between 2010 and 2020, S. D. Hollon wrote the following 85 articles about Depression.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial Treatment of Depression Versus Treatment of PTSD. 2019

Hollon, Steven D. ·The Department of Psychology, Vanderbilt University, Nashville, Tenn. ·Am J Psychiatry · Pubmed #30929505.

ABSTRACT: -- No abstract --

2 Editorial Reviewing psychological treatments for adult depression. 2013

Hollon, Steven D / Cuijpers, Pim. · ·Can J Psychiatry · Pubmed #23870718.

ABSTRACT: -- No abstract --

3 Review Recent Developments in the Treatment of Depression. 2019

Hollon, Steven D / Cohen, Zachary D / Singla, Daisy R / Andrews, Paul W. ·Vanderbilt University. Electronic address: steven.d.hollon@vanderbilt.edu. · University of Pennsylvania. · University of Toronto, Sinai Health System. · McMaster University. ·Behav Ther · Pubmed #30824244.

ABSTRACT: The cognitive and behavioral interventions can be as efficacious as antidepressant medications and more enduring, but some patients will be more likely to respond to one than the other. Recent work has focused on developing sophisticated selection algorithms using machine-learning approaches that answer the question, "What works best for whom?" Moreover, the vast majority of people suffering from depression reside in low- and middle-income countries where access to either psychotherapy or medications is virtually nonexistent. Great strides have been made in training nonspecialist providers (known as task sharing) to overcome this gap. Finally, recent work growing out of evolutionary psychology suggests that antidepressant medications may suppress symptoms at the expense of prolonging the underlying episode so as to increase the risk of relapse whenever someone tries to stop. We address each of these developments and their cumulative implications.

4 Review The Mortality and Myocardial Effects of Antidepressants Are Moderated by Preexisting Cardiovascular Disease: A Meta-Analysis. 2017

Maslej, Marta M / Bolker, Benjamin M / Russell, Marley J / Eaton, Keifer / Durisko, Zachary / Hollon, Steven D / Swanson, G Marie / Thomson, J Anderson / Mulsant, Benoit H / Andrews, Paul W. ·Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, ON, Canada. ·Psychother Psychosom · Pubmed #28903117.

ABSTRACT: BACKGROUND: Antidepressants (ADs) are commonly prescribed medications, but their long-term health effects are debated. ADs disrupt multiple adaptive processes regulated by evolutionarily ancient biochemicals, potentially increasing mortality. However, many ADs also have anticlotting properties that can be efficacious in treating cardiovascular disease. We conducted a meta-analysis assessing the effects of ADs on all-cause mortality and cardiovascular events in general-population and cardiovascular-patient samples. METHODS: Two reviewers independently assessed articles from PubMed, EMBASE, and Google Scholar for AD-related mortality controlling for depression and other comorbidities. From these articles, we extracted information about cardiovascular events, cardiovascular risk status, and AD class. We conducted mixed-effect meta-analyses testing sample type and AD class as moderators of all-cause mortality and new cardiovascular events. RESULTS: Seventeen studies met our search criteria. Sample type consistently moderated health risks. In general-population samples, AD use increased the risks of mortality (HR = 1.33, 95% CI: 1.14-1.55) and new cardiovascular events (HR = 1.14, 95% CI: 1.08-1.21). In cardiovascular patients, AD use did not significantly affect risks. AD class also moderated mortality, but the serotonin reuptake inhibitors were not significantly different from tricyclic ADs (TCAs) (HR = 1.10, 95% CI: 0.93-1.31, p = 0.27). Only "other ADs" were differentiable from TCAs (HR = 1.35, 95% CI: 1.08-1.69). Mortality risk estimates increased when we analyzed the subset of studies controlling for premedication depression, suggesting the absence of confounding by indication. CONCLUSIONS: The results support the hypothesis that ADs are harmful in the general population but less harmful in cardiovascular patients.

5 Review Initial severity of depression and efficacy of cognitive-behavioural therapy: individual-participant data meta-analysis of pill-placebo-controlled trials. 2017

Furukawa, Toshi A / Weitz, Erica S / Tanaka, Shiro / Hollon, Steven D / Hofmann, Stefan G / Andersson, Gerhard / Twisk, Jos / DeRubeis, Robert J / Dimidjian, Sona / Hegerl, Ulrich / Mergl, Roland / Jarrett, Robin B / Vittengl, Jeffrey R / Watanabe, Norio / Cuijpers, Pim. ·Toshi A. Furukawa, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Erica S. Weitz, MA, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Shiro Tanaka, PhD, Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Stefan G. Hofmann, PhD, Department of Psychological and Brain Science, Boston University, Massachusetts, USA; Gerhard Andersson, PhD, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden and Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stokholm, Sweden; Jos Twisk, PhD, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Robert J. DeRubeis, PhD, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Sona Dimidjian, PhD, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA; Ulrich Hegerl, MD, PhD, Roland Mergl, PhD, Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; Robin B. Jarrett, PhD, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Jeffrey R. Vittengl, PhD, Department of Psychology, Truman State University, Kirksville, Missouri, USA; Norio Watanabe, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Pim Cuijpers, PhD, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands furukawa@kuhp.kyoto-u.ac.jp. · Toshi A. Furukawa, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Erica S. Weitz, MA, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Shiro Tanaka, PhD, Department of Pharmacoepidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Steven D. Hollon, PhD, Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA; Stefan G. Hofmann, PhD, Department of Psychological and Brain Science, Boston University, Massachusetts, USA; Gerhard Andersson, PhD, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden and Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stokholm, Sweden; Jos Twisk, PhD, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands; Robert J. DeRubeis, PhD, Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania, USA; Sona Dimidjian, PhD, Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, USA; Ulrich Hegerl, MD, PhD, Roland Mergl, PhD, Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany; Robin B. Jarrett, PhD, Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, Texas, USA; Jeffrey R. Vittengl, PhD, Department of Psychology, Truman State University, Kirksville, Missouri, USA; Norio Watanabe, MD, PhD, Departments of Health Promotion and Human Behavior and of Clinical Epidemiology, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan; Pim Cuijpers, PhD, Department of Clinical Psychology and EMGO Institute for Health and Care Research, VU University Amsterdam, The Netherlands. ·Br J Psychiatry · Pubmed #28104735.

ABSTRACT:

6 Review Does Publication Bias Inflate the Apparent Efficacy of Psychological Treatment for Major Depressive Disorder? A Systematic Review and Meta-Analysis of US National Institutes of Health-Funded Trials. 2015

Driessen, Ellen / Hollon, Steven D / Bockting, Claudi L H / Cuijpers, Pim / Turner, Erick H. ·Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, Amsterdam, The Netherlands. · Department of Psychology, Vanderbilt University, Nashville, Tennessee, United States of America. · Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. · Behavioral Health and Neurosciences Division, VA Portland Health Care System, Portland, Oregon, United States of America; Departments of Psychiatry and Pharmacology, Oregon Health & Science University, Portland, Oregon, United States of America. ·PLoS One · Pubmed #26422604.

ABSTRACT: BACKGROUND: The efficacy of antidepressant medication has been shown empirically to be overestimated due to publication bias, but this has only been inferred statistically with regard to psychological treatment for depression. We assessed directly the extent of study publication bias in trials examining the efficacy of psychological treatment for depression. METHODS AND FINDINGS: We identified US National Institutes of Health grants awarded to fund randomized clinical trials comparing psychological treatment to control conditions or other treatments in patients diagnosed with major depressive disorder for the period 1972-2008, and we determined whether those grants led to publications. For studies that were not published, data were requested from investigators and included in the meta-analyses. Thirteen (23.6%) of the 55 funded grants that began trials did not result in publications, and two others never started. Among comparisons to control conditions, adding unpublished studies (Hedges' g = 0.20; CI95% -0.11~0.51; k = 6) to published studies (g = 0.52; 0.37~0.68; k = 20) reduced the psychotherapy effect size point estimate (g = 0.39; 0.08~0.70) by 25%. Moreover, these findings may overestimate the "true" effect of psychological treatment for depression as outcome reporting bias could not be examined quantitatively. CONCLUSION: The efficacy of psychological interventions for depression has been overestimated in the published literature, just as it has been for pharmacotherapy. Both are efficacious but not to the extent that the published literature would suggest. Funding agencies and journals should archive both original protocols and raw data from treatment trials to allow the detection and correction of outcome reporting bias. Clinicians, guidelines developers, and decision makers should be aware that the published literature overestimates the effects of the predominant treatments for depression.

7 Review The effects of cognitive behavior therapy for adult depression on dysfunctional thinking: A meta-analysis. 2015

Cristea, Ioana A / Huibers, Marcus J H / David, Daniel / Hollon, Steven D / Andersson, Gerhard / Cuijpers, Pim. ·Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania; Clinical Psychology Branch, Department of Surgical, Medical, Molecular and Critical Pathology, University of Pisa, Pisa, Italy. Electronic address: ioana.cristea@ubbcluj.ro. · Department of Clinical Psychology, VU University, Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, The Netherlands. · Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania. · Department of Psychology, Vanderbilt University, Nashville, USA. · Department of Behavioural Sciences and Learning, Linköping University, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden. ·Clin Psychol Rev · Pubmed #26319193.

ABSTRACT: BACKGROUND: It is not clear whether cognitive behavior therapy (CBT) works through changing dysfunctional thinking. Although several primary studies have examined the effects of CBT on dysfunctional thinking, no meta-analysis has yet been conducted. METHOD: We searched for randomized trials comparing CBT for adult depression with control groups or with other therapies and reporting outcomes on dysfunctional thinking. We calculated effect sizes for CBT versus control groups, and separately for CBT versus other psychotherapies and respectively, pharmacotherapy. RESULTS: 26 studies totalizing 2002 patients met inclusion criteria. The quality of the studies was less than optimal. We found a moderate effect of CBT compared to control groups on dysfunctional thinking at post-test (g=0.50; 95% CI: 0.38-0.62), with no differences between the measures used. This result was maintained at follow-up (g=0.46; 95% CI: 0.15-0.78). There was a strong association between the effects on dysfunctional thinking and those on depression. We found no significant differences between CBT and other psychotherapies (g=0.17; p=0.31), except when restrict in outcomes to the Dysfunctional Attitudes Scale (g=0.29). There also was no difference between CBT and pharmacotherapy (g=0.04), though this result was based on only 4 studies. DISCUSSION: While CBT had a robust and stable effect on dysfunctional thoughts, this was not significantly different from what other psychotherapies or pharmacotherapy achieved. This result can be interpreted as confirming the primacy of cognitive change in symptom change, irrespective of how it is attained, as well as supporting the idea that dysfunctional thoughts are simply another symptom that changes subsequent to treatment.

8 Review A lifetime approach to major depressive disorder: The contributions of psychological interventions in preventing relapse and recurrence. 2015

Bockting, Claudi L / Hollon, Steven D / Jarrett, Robin B / Kuyken, Willem / Dobson, Keith. ·Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands. Electronic address: c.l.h.bockting@uu.nl. · Department of Psychology, Vanderbilt University, Nashville, TN, USA. · Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Psychiatry, University of Oxford, Oxford OX1 2JD, UK. · Department of Psychology, University of Calgary, Alberta, Canada. ·Clin Psychol Rev · Pubmed #25754289.

ABSTRACT: Major depressive disorder (MDD) is highly disabling and typically runs a recurrent course. Knowledge about prevention of relapse and recurrence is crucial to the long-term welfare of people who suffer from this disorder. This article provides an overview of the current evidence for the prevention of relapse and recurrence using psychological interventions. We first describe a conceptual framework to preventive interventions based on: acute treatment; continuation treatment, or; prevention strategies for patients in remission. In brief, cognitive-behavioral interventions, delivered during the acute phase, appear to have an enduring effect that protects patients against relapse and perhaps others from recurrence following treatment termination. Similarly, continuation treatment with either cognitive therapy or perhaps interpersonal psychotherapy appears to reduce risk for relapse and maintenance treatment appears to reduce risk for recurrence. Preventive relapse strategies like preventive cognitive therapy or mindfulness based cognitive therapy (MBCT) applied to patients in remission protects against subsequent relapse and perhaps recurrence. There is some preliminary evidence of specific mediation via changing the content or the process of cognition. Continuation CT and preventive interventions started after remission (CBT, MBCT) seem to have the largest differential effects for individuals that need them the most. Those who have the greatest risk for relapse and recurrence including patients with unstable remission, more previous episodes, potentially childhood trauma, early age of onset. These prescriptive indications, if confirmed in future research, may point the way to personalizing prevention strategies. Doing so, may maximize the efficiency with which they are applied and have the potential to target the mechanisms that appear to underlie these effects. This may help make this prevention strategies more efficacious.

9 Review Effectiveness of psychological interventions in preventing recurrence of depressive disorder: meta-analysis and meta-regression. 2015

Biesheuvel-Leliefeld, Karolien E M / Kok, Gemma D / Bockting, Claudi L H / Cuijpers, Pim / Hollon, Steven D / van Marwijk, Harm W J / Smit, Filip. ·Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. Electronic address: k.leliefeld@vumc.nl. · Department of Clinical and Experimental Psychology, Groningen University, Groningen, The Netherlands. · Department of Clinical Psychology, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, The Netherlands. · Department of Clinical Psychology, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, The Netherlands; Leuphana University, Lüneburg, Germany. · Department of Psychology, Vanderbilt University, Nashville, TN, USA. · Department of General Practice and Elderly Care Medicine, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. · Department of Clinical Psychology, EMGO Institute for Health and Care Research, VU University and VU University Medical Centre, Amsterdam, The Netherlands; Department of Public Mental Health, Trimbos Institute (Netherlands Institute of Mental Health and Addiction), Utrecht, The Netherlands; Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands. ·J Affect Disord · Pubmed #25553400.

ABSTRACT: BACKGROUND: Major depression is probably best seen as a chronically recurrent disorder, with patients experiencing another depressive episode after remission. Therefore, attention to reduce the risk of relapse or recurrence after remission is warranted. The aim of this review is to meta-analytically examine the effectiveness of psychological interventions to reduce relapse or recurrence rates of depressive disorder. METHODS: We systematically reviewed the pertinent trial literature until May 2014. The random-effects model was used to compute the pooled relative risk of relapse or recurrence (RR). A distinction was made between two comparator conditions: (1) treatment-as-usual and (2) the use of antidepressants. Other sources of heterogeneity in the data were explored using meta-regression. RESULTS: Twenty-five randomised trials met inclusion criteria. Preventive psychological interventions were significantly better than treatment-as-usual in reducing the risk of relapse or recurrence (RR=0.64, 95% CI=0.53-0.76, z=4.89, p<0.001, NNT=5) and also more successful than antidepressants (RR=0.83, 95% CI=0.70-0.97, z=2.40, p=0.017, NNT=13). Meta-regression showed homogeneity in effect size across a range of study, population and intervention characteristics, but the preventive effect of psychological intervention was usually better when the prevention was preceded by treatment in the acute phase (b=-1.94, SEb=0.68, z=-2.84, p=0.005). LIMITATIONS: Differences between the primary studies in methodological design, composition of the patient groups and type of intervention may have caused heterogeneity in the data, but could not be evaluated in a meta-regression owing to poor reporting. CONCLUSIONS: We conclude that there is supporting evidence that preventive psychological interventions reduce the risk of relapse or recurrence in major depression.

10 Review [The efficacy of psychological treatments for depression: a review of recent research findings]. 2014

Driessen, E / Cuijpers, P / Hollon, S D / Van, H L / Dekker, J J M. · ·Tijdschr Psychiatr · Pubmed #25070570.

ABSTRACT: BACKGROUND: Psychological treatments for depression have been shown to be effective, but there is room for improvement. AIM: To summarise new research findings concerning the efficacy of psychological treatments for depression, as reported in a recent dissertation. METHOD: Four systematic reviews and meta-analyses and one randomised clinical trial are described. RESULTS: As has been shown in the case of patients treated with antidepressants, the efficacy of psychological treatments for depression when compared to strict control conditions, might be greater in patients with more severe depressive symptoms than in patients with milder symptoms. The efficacy of psychological treatments for depression when compared to control conditions is overestimated as a result of systematic publication of positive findings, as has been reported with regard to antidepressant medication too. There is increasing academic support for the efficacy of brief psychodynamic therapy for depression and there are no differences in the efficacy of short-term psychodynamic supportive psychotherapy and cognitive behavioural therapy for depression. Certain patient characteristics were found to be related to the differential efficacy of these two types of psychological treatments, but further validation is needed. A large number of patients with depression who seek help from second-line psychiatric clinics in the Netherlands fail to achieve remission following psychological treatment, irrespective of whether that treatment is combined with antidepressants. CONCLUSION: Improved efficacy of psychological treatments for depression is urgently needed and can be facilitated by means of high quality research.

11 Review The effects of psychotherapies for major depression in adults on remission, recovery and improvement: a meta-analysis. 2014

Cuijpers, Pim / Karyotaki, Eirini / Weitz, Erica / Andersson, Gerhard / Hollon, Steven D / van Straten, Annemieke. ·Department of Clinical Psychology, VU University Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, The Netherlands; Leuphana University, Lüneburg, Germany. Electronic address: p.cuijpers@vu.nl. · Department of Clinical Psychology, VU University Amsterdam, The Netherlands; EMGO Institute for Health and Care Research, VU University and VU University Medical Center Amsterdam, The Netherlands. · Department of Behavioral Sciences and Learning, Swedish Institute for Disability Research, Linköping University, Sweden; Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden. · Vanderbilt University, Nashville, Tennessee, USA. ·J Affect Disord · Pubmed #24679399.

ABSTRACT: BACKGROUND: Standardised effect sizes have been criticized because they are difficult to interpret and offer little clinical information. This meta-analyses examine the extent of actual improvement, the absolute numbers of patients no longer meeting criteria for major depression, and absolute rates of response and remission. METHODS: We conducted a meta-analysis of 92 studies with 181 conditions (134 psychotherapy and 47 control conditions) with 6937 patients meeting criteria for major depressive disorder. Within these conditions, we calculated the absolute number of patients no longer meeting criteria for major depression, rates of response and remission, and the absolute reduction on the BDI, BDI-II, and HAM-D. RESULTS: After treatment, 62% of patients no longer met criteria for MDD in the psychotherapy conditions. However, 43% of participants in the control conditions and 48% of people in the care-as-usual conditions no longer met criteria for MDD, suggesting that the additional value of psychotherapy compared to care-as-usual would be 14%. For response and remission, comparable results were found, with less than half of the patients meeting criteria for response and remission after psychotherapy. Additionally, a considerable proportion of response and remission was also found in control conditions. In the psychotherapy conditions, scores on the BDI were reduced by 13.42 points, 15.12 points on the BDI-II, and 10.28 points on the HAM-D. In the control conditions, these reductions were 4.56, 4.68, and 5.29. DISCUSSION: Psychotherapy contributes to improvement in depressed patients, but improvement in control conditions is also considerable.

12 Review The methods and outcomes of cultural adaptations of psychological treatments for depressive disorders: a systematic review. 2014

Chowdhary, N / Jotheeswaran, A T / Nadkarni, A / Hollon, S D / King, M / Jordans, M J D / Rahman, A / Verdeli, H / Araya, R / Patel, V. ·Centre for Global Mental Health, London School of Hygiene and Tropical Medicine, UK, and Sangath, India. · Institute of Psychiatry, King's College, London, UK, Public Health Foundation of India, and Sangath, India. · London School of Hygiene and Tropical Medicine, UK. · Vanderbilt University, Nashville, TN, USA. · Faculty of Brain Sciences, University College London Medical School, UK. · University of Liverpool, UK. · Teachers College, Columbia University and Columbia College of Physicians and Surgeons, NY, USA. · University of Bristol, UK. ·Psychol Med · Pubmed #23866176.

ABSTRACT: BACKGROUND: Cultural adaptations of evidence-based psychological treatments (PTs) are important to enhance their universal applicability. The aim of this study was to review systematically the literature on adaptations of PTs for depressive disorders for ethnic minorities in Western countries and for any population in non-Western countries to describe the process, extent and nature of the adaptations and the effectiveness of the adapted treatments. METHOD: Controlled trials were identified using database searches, key informants, previous reviews and reference lists. Data on the process and details of the adaptations were analyzed using qualitative methods and meta-analysis was used to assess treatment effectiveness. RESULTS: Twenty studies were included in this review, of which 16 were included in the meta-analysis. The process of adaptation was reported in two-thirds of the studies. Most adaptations were found in the dimensions of language, context and therapist delivering the treatment. The meta-analysis revealed a statistically significant benefit in favor of the adapted treatment [standardized mean difference (SMD) -0.72, 95% confidence interval (CI) -0.94 to -0.49]. CONCLUSIONS: Cultural adaptations of PTs follow a systematic procedure and lead primarily to adaptations in the implementation of the treatments rather than their content. Such PTs are effective in the treatment of depressive disorders in populations other than those for whom they were originally developed.

13 Review Double trouble: does co-morbid chronic somatic illness increase risk for recurrence in depression? A systematic review. 2013

Kok, Gemma D / Bockting, Claudi L H / Burger, Huibert / Hannig, Wiebke / Pijnenborg, Gerdina H M / Cuijpers, Pim / Hollon, Steven D. ·Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands. ·PLoS One · Pubmed #23472087.

ABSTRACT: OBJECTIVE: To perform a systematic review, and if possible a meta-analysis, to establish whether depressed patients with co-morbid chronic somatic illnesses are a high risk "double trouble" group for depressive recurrence. METHOD: The databases PubMed, EMbase and PsycINFO were systematically searched until the 4(th) of December 2012 by using MeSH and free text terms. Additionally, reference lists of retrieved publications and treatment guidelines were reviewed, and experts were consulted. Inclusion criteria were: depression had to be measured at least twice during the study with qualified instruments and the chronic somatic illness had to be assessed by self-report or by a medical professional. Information on depressive recurrence was extracted and additionally risk ratios of recurrence were calculated. RESULTS: The search generated four articles that fulfilled our inclusion criteria. These studies showed no differences in recurrence over one- two- three- and 6.5 years of follow-up for a total of 2010 depressed patients of which 694 patients with a co-morbid chronic somatic illness versus 1316 patients without (Study 1: RR = 0.49, 95% CI, 0.17-1.41 at one year follow-up and RR = 1.37, 95% CI, 0.78-2.41 at two year follow-up; Study 2: RR = 0.94, 95% CI, 0.65-1.36 at two year follow-up; Study 3: RR = 1.15, 95% CI, 0.40-3.27 at one year follow-up; RR = 1.07, 95% CI, 0.48-2.42 at two year follow-up and RR = 0.99, 95% CI,0.55-1.77 at 6.5 years follow-up; Study 4: RR = 1.16, 95% CI, 0.86-1.57 at three year follow-up). CONCLUSION: We found no association between a heightened risk for depressive recurrence and co-morbid chronic somatic illnesses. There is a need for more longitudinal studies to justify the current specific treatment advice such as long-term pharmacological maintenance treatment for this presumed "double trouble" group.

14 Review Cognitive and behavior therapy in the treatment and prevention of depression. 2011

Hollon, Steven D. ·Vanderbilt University, Tennessee. steven.d.hollon@Vanderbilt.Edu ·Depress Anxiety · Pubmed #21456036.

ABSTRACT: -- No abstract --

15 Clinical Trial Sudden gains in routine care cognitive behavioral therapy for depression: A replication with extensions. 2017

Wucherpfennig, Felix / Rubel, Julian A / Hollon, Steven D / Lutz, Wolfgang. ·Clinical Psychology and Psychotherapy, Department of Psychology, University of Trier, D-54296 Trier, Germany. Electronic address: wucherpfennig@uni-trier.de. · Clinical Psychology and Psychotherapy, Department of Psychology, University of Trier, D-54296 Trier, Germany. · Department of Psychology, Vanderbilt University, TN 37240 Nashville, United States. ·Behav Res Ther · Pubmed #27846418.

ABSTRACT: BACKGROUND: Over the last decade, a substantial amount of findings have been reported on the association between sudden gains (large symptom improvements in a between-session interval) and treatment outcome. Accurate replications of previous findings are needed to tackle inconsistencies and to shed light on the clinical implications of sudden gains. This study investigates whether similar effects of sudden gains can be expected under routine care conditions, when the patients are comparable to those examined in the original study by Tang and DeRubeis (1999). METHOD: Using propensity score matching (PSM), 462 patients treated with cognitive behavioral therapy (CBT) under routine conditions were matched stepwise to patients of the original study on sudden gains, a randomized controlled CBT trial (RCT). RESULTS: After the application of PSM, the effects of sudden gains on treatment outcome were similar to those found by Tang and DeRubeis (1999). The closer the match between the RCT and the naturalistic sample, the more similar the association between sudden gains and treatment outcome. CONCLUSION: Sudden gains seem to have a significant impact on recovery rates, even in treatments under routine care. Results suggest that one important aspect of replication success is to control for confounding baseline covariates.

16 Clinical Trial The clinical effectiveness of evidence-based interventions for depression: a pragmatic trial in routine practice. 2013

Peeters, Frenk / Huibers, Marcus / Roelofs, Jeffrey / van Breukelen, Gerard / Hollon, Steven D / Markowitz, John C / van Os, Jim / Arntz, Arnoud. ·Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, Maastricht, The Netherlands. f.peeters@maastrichtuniversity.nl ·J Affect Disord · Pubmed #22985486.

ABSTRACT: BACKGROUND: Controversy persists about how effectively empirically-supported treatments for major depression work in actual clinical practice as well as how patients choose among them. We examined the acute phase effectiveness of cognitive therapy (CT), interpersonal psychotherapy (IPT), and combined psychotherapy-pharmacotherapy (PHT) in a naturalistic setting, allowing patients their choice of treatment. METHODS: The study compared CT (n=63), IPT (n=56), CT-PHT (n=34), and IPT-PHT (n=21) for 174 subjects with major depression in a secondary care mood disorders clinic. Patient preference, rather than randomization, determined treatment selection. The Beck Depression Inventory-II (BDI) was the primary outcome variable. Exclusion criteria were minimal. RESULTS: All treatments were associated with a reduction in depressive symptoms, with a 35% remission rate by week 26. Overall improvement was well within ranges reported in efficacy trials. On average, treatment effects of the different interventions straddled the same range, but moderation analyses revealed that BDI scores dropped faster in the first 16 weeks in patients who received CT alone than patients who received CT and pharmacotherapy, a pattern not found in patients who received IPT (with or without pharmacotherapy). LIMITATIONS: Limitations consist of a modest sample size, choice of treatment was made by participants which may have been influenced by many sources, and the absence of a non-active control group. CONCLUSIONS: This study supports the effectiveness of empirically-supported antidepressant treatments selected by patients in routine settings, and provides an indication that speed of therapeutic response may vary amongst treatments.

17 Clinical Trial Is prior course of illness relevant to acute or longer-term outcomes in depressed out-patients? A STAR*D report. 2012

Rush, A J / Wisniewski, S R / Zisook, S / Fava, M / Sung, S C / Haley, C L / Chan, H N / Gilmer, W S / Warden, D / Nierenberg, A A / Balasubramani, G K / Gaynes, B N / Trivedi, M H / Hollon, S D. ·Office of Clinical Sciences, Duke-NUS Graduate Medical School Singapore, Singapore. ·Psychol Med · Pubmed #22008447.

ABSTRACT: BACKGROUND: Major depressive disorder (MDD) is commonly chronic and/or recurrent. We aimed to determine whether a chronic and/or recurrent course of MDD is associated with acute and longer-term MDD treatment outcomes. METHOD: This cohort study recruited out-patients aged 18-75 years with non-psychotic MDD from 18 primary and 23 psychiatric care clinics across the USA. Participants were grouped as: chronic (index episode >2 years) and recurrent (n = 398); chronic non-recurrent (n=257); non-chronic recurrent (n=1614); and non-chronic non-recurrent (n = 387). Acute treatment was up to 14 weeks of citalopram (≤ 60 mg/day) with up to 12 months of follow-up treatment. The primary outcomes for this report were remission [16-item Quick Inventory of Depressive Symptomatology - Self-Rated (QIDS-SR(16)) ≤ 5] or response (≥ 50% reduction from baseline in QIDS-SR(16)) and time to first relapse [first QIDS-SR16 by Interactive Voice Response (IVR) ≥ 11]. RESULTS: Most participants (85%) had a chronic and/or recurrent course; 15% had both. Chronic index episode was associated with greater sociodemographic disadvantage. Recurrent course was associated with earlier age of onset and greater family histories of depression and substance abuse. Remission rates were lowest and slowest for those with chronic index episodes. For participants in remission entering follow-up, relapse was most likely for the chronic and recurrent group, and least likely for the non-chronic, non-recurrent group. For participants not in remission when entering follow-up, prior course was unrelated to relapse. CONCLUSIONS: Recurrent MDD is the norm for out-patients, of whom 15% also have a chronic index episode. Chronic and recurrent course of MDD may be useful in predicting acute and long-term MDD treatment outcomes.

18 Article Temporal pathways of change in two randomized controlled trials for depression and harmful drinking in Goa, India. 2020

Singla, Daisy R / Hollon, Steven D / Velleman, Richard / Weobong, Benedict / Nadkarni, Abhijit / Fairburn, Christopher G / Bhat, Bhargav / Gurav, Mahesh / Anand, Arpita / McCambridge, Jim / Dimidjian, Sona / Patel, Vikram. ·Department of Psychiatry, University of Toronto and Sinai Health System, Toronto, Canada. · Department of Psychology, Vanderbilt University, Nashville, Tennessee, USA. · Department of Psychology, University of Bath, Bath, UK. · Sangath, Alto Porvorim, Goa, India. · Centre for Global Mental Health, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. · Department of Social & Behavioral Sciences, School of Public Health, University of Ghana, Accra, Ghana. · Department of Psychiatry, Warneford Hospital, Oxford, UK. · Department of Health Sciences, University of York, York, UK. · Department of Psychology and Neuroscience, University of Colorado Boulder, Boulder, Colorado, USA. · Department of Global Health & Social Medicine, Harvard Medical School, Cambridge, USA. · Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA. ·Psychol Med · Pubmed #30616698.

ABSTRACT: BACKGROUND: The current study explored the temporal pathways of change within two treatments, the Healthy Activity Program (HAP) for depression and the Counselling for Alcohol Problems (CAP) Program for harmful drinking. METHODS: The study took place in the context of two parallel randomized controlled trials in Goa, India. N = 50 random participants who met a priori criteria were selected from each treatment trial and examined for potential direct and mediational pathways. In HAP, we examined the predictive roles of therapy quality and patient-reported activation, assessing whether activation mediated the effects of therapy quality on depression (Patient Health Questionnaire-9) outcomes. In CAP, we examined the predictive roles of therapy quality and patient change- and counter-change-talk, assessing whether change- or counter-change-talk mediated the effects of therapy quality on daily alcohol consumption. RESULTS: In HAP, therapy quality (both general and treatment-specific skills) was associated with patient activation; patient activation but not therapy quality significantly predicted depression outcomes, and patient activation mediated the effects of higher general skills on subsequent clinical outcomes [a × b = -2.555, 95% confidence interval (CI) -5.811 to -0.142]. In CAP, higher treatment-specific skills, but not general skills, were directly associated with drinking outcomes, and reduced levels of counter-change talk both independently predicted, and mediated the effects of higher general skills on, reduced alcohol consumption (a × b = -24.515, 95% CI -41.190 to -11.060). Change talk did not predict alcohol consumption and was not correlated with counter-change talk. CONCLUSION: These findings suggest that therapy quality in early sessions operated through increased patient activation and reduced counter-change talk to reduce depression and harmful drinking respectively.

19 Article Distress and anhedonia as predictors of depression treatment outcome: A secondary analysis of a randomized clinical trial. 2019

Khazanov, Gabriela K / Xu, Colin / Dunn, Barnaby D / Cohen, Zachary D / DeRubeis, Robert J / Hollon, Steven D. ·Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA, 19104, USA. Electronic address: kattang@sas.upenn.edu. · Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA, 19104, USA. Electronic address: colinxu@sas.upenn.edu. · Mood Disorders Centre, University of Exeter. Sir Henry Wellcome Building for Mood Disorders Research, University of Exeter, Perry Road, EX4 4QG, UK. Electronic address: B.D.Dunn@exeter.ac.uk. · Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA, 19104, USA. Electronic address: zcohen@sas.upenn.edu. · Department of Psychology, University of Pennsylvania, 425 S. University Avenue, Philadelphia, PA, 19104, USA. Electronic address: derubeis@psych.upenn.edu. · Department of Psychology, Vanderbilt University. 2301 Vanderbilt Place, Nashville, TN, 37240, USA. Electronic address: steven.d.hollon@vanderbilt.edu. ·Behav Res Ther · Pubmed #31896529.

ABSTRACT: Two core features of depression include depressed mood (heightened distress) and anhedonia (reduced pleasure). Despite their centrality to depression, studies have not examined their contribution to treatment outcomes in a randomized clinical trial providing mainstream treatments like antidepressant medications (ADM) and cognitive therapy (CT). We used baseline distress and anhedonia derived from a factor analysis of the Mood and Anxiety Symptom Questionnaire to predict remission and recovery in 433 individuals with recurrent/chronic major depressive disorder. Patients were provided with only ADM or both ADM and CT. Overall, higher baseline distress and anhedonia predicted longer times to remission within one year and recovery within three years. When controlling for treatment condition, distress improved prediction of outcomes over and above anhedonia, while anhedonia did not improve prediction of outcomes over and above distress. Interactions with treatment condition demonstrated that individuals with higher distress and anhedonia benefited from receiving CT in addition to ADM, whereas there was no added benefit of CT for individuals with lower distress and anhedonia. Assessing distress and anhedonia prior to treatment may help select patients who will benefit most from CT in addition to ADM. For the treatments and outcome measures tested, utilizing distress to guide treatment planning may yield the greatest benefit. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00057577.

20 Article What factors indicate prognosis for adults with depression in primary care? A protocol for meta-analyses of individual patient data using the Dep-GP database. 2019

Buckman, Joshua E J / Saunders, Rob / Cohen, Zachary D / Clarke, Katherine / Ambler, Gareth / DeRubeis, Robert J / Gilbody, Simon / Hollon, Steven D / Kendrick, Tony / Watkins, Edward / White, Ian R / Lewis, Glyn / Pilling, Stephen. ·Centre for Outcomes Research and Effectiveness (CORE), Research Department of Clinical, Educational & Health Psychology, University College London, London, WC1E 7HB, UK. · Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, 90095, USA. · Statistical Science, University College London, London, WC1E 7HB, UK. · School of Arts and Sciences, Department of Psychology, University of Pennsylvania, Philadelphia, PA, 19104-60185, USA. · Department of Health Sciences, University of York, York, YO10 5DD, UK. · Department of Psychology, Vanderbilt University, Nashville, TN, 407817, USA. · Primary Care & Population Sciences, Faculty of Medicine, University of Southampton, Southampton, SO16 5ST, UK. · Department of Psychology, University of Exeter, Exeter, EX4 4QG, UK. · Institute of Clinical Trials and Methodology, MRC Clinical Trials Unit, University College London, London, WC1V 6LJ, UK. · Division of Psychiatry, University College London, London, W1T 7NF, UK. ·Wellcome Open Res · Pubmed #31815189.

ABSTRACT:

21 Article Effects of psychological treatment of mental health problems in pregnant women to protect their offspring: randomised controlled trial. 2019

Burger, Huibert / Verbeek, Tjitte / Aris-Meijer, Judith L / Beijers, Chantal / Mol, Ben W / Hollon, Steven D / Ormel, Johan / van Pampus, Mariëlle G / Bockting, Claudi L H. ·Associate Professor of Clinical Epidemiology, Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen; and Department of Epidemiology, University Medical Centre Groningen, The Netherlands. · Researcher, Department of General Practice and Elderly Care Medicine, University Medical Centre Groningen; and Department of Epidemiology, University Medical Centre Groningen, The Netherlands. · Researcher, Department of Epidemiology, University Medical Centre Groningen, The Netherlands. · Researcher, Department of Psychiatry, University Medical Centre Groningen, The Netherlands. · Professor of Obstetrics and Gynaecology, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia. · Professor of Psychology, Department of Psychology, Vanderbilt University, Tennessee, USA. · Professor of Social Psychiatry and Psychiatric Epidemiology, Department of Psychiatry, University Medical Centre Groningen, The Netherlands. · Gynaecologist, Department of Obstetrics and Gynaecology, Onze Lieve Vrouwe Gasthuis, The Netherlands. · Professor of Clinical Psychology, Department of Psychiatry, Amsterdam University Medical Centre; and Institute for Advanced Study, University of Amsterdam, The Netherlands. ·Br J Psychiatry · Pubmed #31806071.

ABSTRACT: BACKGROUND: Perinatal depression and anxiety are associated with unfavourable child outcomes. AIMS: To assess among women with antenatal depression or anxiety the effectiveness of prenatally initiated cognitive-behavioural therapy (CBT) on mother and child compared with care as usual (CAU). Trial registration: Netherlands Trial Register number NTR2242. METHOD: Pregnant women (n = 282) who screened positive for symptoms of depression and/or anxiety were randomised to either CBT (n = 140) or CAU (n = 142). The primary outcome was child behavioural and emotional problems at age 18 months, assessed using the Child Behavior Checklist (CBCL). Secondary outcomes were maternal symptoms during and up to 18 months after pregnancy, neonatal outcomes, mother-infant bonding and child cognitive and motor development at age 18 months. RESULTS: In total, 94 (67%) women in the CBT group and 98 (69%) in the CAU group completed the study. The mean CBCL Total Problems score was non-significantly higher in the CBT group than in the CAU group (mean difference: 1.38 (95% CI -1.82 to 4.57); t = 0.85, P = 0.399). No effects on secondary outcomes were observed except for depression and anxiety, which were higher in the CBT group than in the CAU group at mid-pregnancy. A post hoc analysis of the 98 women with anxiety disorders showed lower infant gestational age at delivery in the CBT than in the CAU group. CONCLUSIONS: Prenatally initiated CBT did not improve maternal symptoms or child outcomes among non-help-seeking women with antenatal depression or anxiety. Our findings are not in line with present recommendations for universal screening and treatment for antenatal depression or anxiety, and future work may include the relevance of baseline help-seeking.

22 Article The Roles of Early Response and Sudden Gains on Depression Outcomes: Findings From a Randomized Controlled Trial of Behavioral Activation in Goa, India. 2019

Singla, Daisy R / Hollon, Steven D / Fairburn, Christopher G / Dimidjian, Sona / Patel, Vikram. ·Department of Psychiatry, University of Toronto, and Sinai Health System, Toronto, Canada. · Department of Psychology, Vanderbilt University. · Department of Psychiatry, Warneford Hospital, University of Oxford. · Department of Psychology and Neuroscience, University of Colorado Boulder. · Sangath Center, Goa, India. · Department of Global Health and Social Medicine, Harvard Medical School. · Department of Global Health and Population, Harvard TH Chan School of Public Health. ·Clin Psychol Sci · Pubmed #31380144.

ABSTRACT: The Healthy Activity Program (HAP), a brief, lay-counselor-delivered, behavioral activation psychological treatment, was found to be effective in reducing depressive symptoms among primary care attendees in India. We now examine whether early response predicts depression (PHQ-9) outcomes at the primary endpoint of 3 months and sustained recovery at 12 months after enrollment and the extent to which this effect is influenced by sudden gains in the context of the larger randomized controlled trial. HAP participants (

23 Article Resilience and anxiety or depression among resettled Bhutanese adults in the United States. 2019

Poudel-Tandukar, Kalpana / Chandler, Genevieve E / Jacelon, Cynthia S / Gautam, Bhuwan / Bertone-Johnson, Elizabeth R / Hollon, Steven D. ·1 College of Nursing, University of Massachusetts Amherst, Amherst, MA, USA. · 2 Bhutanese Society of Western Massachusetts, Springfield, MA, USA. · 3 School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, MA, USA. · 4 Department of Psychology, Vanderbilt University, Nashville, TN, USA. ·Int J Soc Psychiatry · Pubmed #31288604.

ABSTRACT: BACKGROUND: Resilience, or an individual's positive response in managing life's adversities, is of increasing interest in addressing the mental health disparities in refugees. Although the link between stressful life events and poor mental health is established, research on the role of resilience on the mental health of refugees is limited. AIMS: This study assessed the association between resilience and anxiety or depression in resettled Bhutanese adults in Western Massachusetts. METHODS: A cross-sectional survey was conducted among 225 Bhutanese (men: 113, women: 112) refugees aged 20-65 residing in Massachusetts. Resilience was measured with the 25-item Wagnild and Young's Resilience Scale including two constructs as follows: a 17-item 'personal competence' that measures self-reliance, independence, determination, resourcefulness, mastery and perseverance and an 8-item 'acceptance of self and life' that measures adaptability, flexibility and a balanced perspective of life. Higher total scores indicate greater resilience. The Hopkins Symptom Checklist-25 was used to measure anxiety (10-item) and depression (15-item) with a cutoff mean score of ⩾1.75 for moderate to severe symptoms. Associations of resilience with anxiety or depression scores were assessed using multiple-linear and logistic regression analyses. RESULTS: The proportion of participants with above threshold anxiety and depression were 34.2% and 24%, respectively. Resilience was inversely associated with both anxiety (beta for 1 unit change in resilience scores: β = -0.026; CONCLUSION: Higher resilience was associated with reduced anxiety and depression among Bhutanese with personal competence resilience accounting for most of the effects. These findings suggest the potential targets for mental-health intervention to improve resilience in refugees.

24 Article The symptom-specific efficacy of antidepressant medication vs. cognitive behavioral therapy in the treatment of depression: results from an individual patient data meta-analysis. 2019

Boschloo, Lynn / Bekhuis, Ella / Weitz, Erica S / Reijnders, Mirjam / DeRubeis, Robert J / Dimidjian, Sona / Dunner, David L / Dunlop, Boadie W / Hegerl, Ulrich / Hollon, Steven D / Jarrett, Robin B / Kennedy, Sidney H / Miranda, Jeanne / Mohr, David C / Simons, Anne D / Parker, Gordon / Petrak, Frank / Herpertz, Stephan / Quilty, Lena C / John Rush, A / Segal, Zindel V / Vittengl, Jeffrey R / Schoevers, Robert A / Cuijpers, Pim. ·Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. · Department of Psychiatry and Interdisciplinary Center Psychopathology and Emotion Regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. · Department of Psychology, University of Pennsylvania, Philadelphia, PA, USA. · Department of Psychology and Neuroscience, University of Colorado, Boulder, CO, USA. · Center for Anxiety and Depression, Mercer Island, Washington, WA, USA. · Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA. · Department of Psychiatry and Psychotherapy, University of Leipzig, Leipzig, Germany. · Department of Psychology, Vanderbilt University, Nashville, TN, USA. · Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA. · Department of Psychiatry, University of Toronto, Toronto, ON, Canada. · Health Services Research Center, Neuropsychiatric Institute, University of California, Los Angeles, CA, USA. · Center for Behavioral Intervention Technologies, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA. · Department of Psychology, University of Notre Dame, Notre Dame, IN, USA. · School of Psychiatry, University of New South Wales, Sydney, NSW, Australia. · Department of Psychosomatic Medicine and Psychotherapy, LWL-University Clinic Bochum, Ruhr University Bochum, Bochum, Germany. · Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada. · Duke-National University of Singapore Graduate Medical School, Singapore. · Department of Psychiatry, Duke Medical School, Durham, NC, USA. · Texas Tech University Health Sciences Center, Permian Basin, TX, USA. · Department of Psychology, University of Toronto Scarborough, Toronto, ON, Canada. · Department of Psychology, Truman State University, Kirksville, MO, USA. ·World Psychiatry · Pubmed #31059603.

ABSTRACT: A recent individual patient data meta-analysis showed that antidepressant medication is slightly more efficacious than cognitive behavioral therapy (CBT) in reducing overall depression severity in patients with a DSM-defined depressive disorder. We used an update of that dataset, based on seventeen randomized clinical trials, to examine the comparative efficacy of antidepressant medication vs. CBT in more detail by focusing on individual depressive symptoms as assessed with the 17-item Hamilton Rating Scale for Depression. Five symptoms (i.e., "depressed mood" , "feelings of guilt" , "suicidal thoughts" , "psychic anxiety" and "general somatic symptoms") showed larger improvements in the medication compared to the CBT condition (effect sizes ranging from .13 to .16), whereas no differences were found for the twelve other symptoms. In addition, network estimation techniques revealed that all effects, except that on "depressed mood" , were direct and could not be explained by any of the other direct or indirect treatment effects. Exploratory analyses showed that information about the symptom-specific efficacy could help in identifying those patients who, based on their pre-treatment symptomatology, are likely to benefit more from antidepressant medication than from CBT (effect size of .30) versus those for whom both treatments are likely to be equally efficacious. Overall, our symptom-oriented approach results in a more thorough evaluation of the efficacy of antidepressant medication over CBT and shows potential in "precision psychiatry" .

25 Article Preventive cognitive therapy versus care as usual in cognitive behavioral therapy responders: A randomized controlled trial. 2019

de Jonge, Margo / Bockting, Claudi L H / Kikkert, Martijn J / van Dijk, Maarten K / van Schaik, Digna J F / Peen, Jaap / Hollon, Steven D / Dekker, Jack J M. ·Department of Research, Arkin. · Department of Psychiatry, Amsterdam Universitair Medische Centra. · Dimence Mental Health Care Centre. · Department of Research and Innovation, GGZ inGeest. · Department of Psychology, Vanderbilt University. ·J Consult Clin Psychol · Pubmed #31008635.

ABSTRACT: OBJECTIVE: The optimization of long-term outcomes is an important goal in the treatment of major depressive disorder. Offering subsequent preventive cognitive therapy (PCT) to patients who responded to acute cognitive behavioral therapy (CBT) may reduce the risk of relapse/recurrence. METHOD: Therefore, a multicenter randomized controlled trial was conducted comparing the addition of eight weekly sessions of PCT to care as usual (CAU) versus CAU alone in patients with a history of depression in remission following treatment with CBT. A total of 214 recurrently depressed patients who remitted following treatment with CBT were randomized to PCT (n = 107) or CAU (n = 107). Primary outcome was time to relapse/recurrence over 15 months and was assessed by the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID-I). Secondary outcomes were depressive symptoms measured by the Inventory of Depressive Symptomatology-Self Report and number and severity of relapses/recurrences measured by the SCID-I. RESULTS: Over the 15-month follow-up, the addition of PCT significantly delayed time to relapse/recurrence relative to CAU alone, hazard ratio = 1.807 (number needed to treat = 8.1), p = .02, 95% CI [1.029, 3.174]. No significant differences were found between the conditions on number or severity of relapses/recurrences and residual symptoms. CONCLUSION: Adding PCT was significantly more effective than CAU alone in delaying time to relapse/recurrence of depression over a period of 15 months among CBT responders. After response on CBT, therapists should consider providing PCT to recurrently depressed patients. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

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