Effectiveness of Cognitive Behavioral Therapy in Preventing the Recurrence of Depression

Depresyon Nüksünün Önlenmesinde Bilişsel Davranışçı Terapinin Etkinliği

Quite a limited number of studies use non-pharmacological strategies for preventing the recurrence in depression. It was found that Cognitive Behavioral Therapy (CBT) provided a significantly lower rate of recurrence in depression symptoms throughout a two-year follow-up.

In a study, forty patients with major depression, who experienced recurrences though having been successfully treated with the use of antidepressants, were randomly divided into two groups. The first group was arranged to receive pharmacotherapy and CBT, and the second group to receive pharmacotherapy and clinical treatment.  The antidepressant drugs of both groups were reduced and then cut within two sessions. Both groups were assessed by the same psychiatrist. The patients were subjected to a six-year follow-up. No antidepressants were used throughout this period of time unless there was a recurrence. The CBT treatment consisted of three main components: treatment of depression symptoms, changes in lifestyle, and the state of wellbeing. The patients were monitored at regular intervals following the treatment.

At the end of this six-year follow-up, CBT achieved a significantly lower rate of recurrence (40%), compared to clinical treatment (90%). Thus, the group that took CBT had a significantly lower number of recurrences, compared to the clinical treatment group. This study shows that the use of CBT in the post-pharmacotherapy period reduces the recurrence of depression, and that it can ensure recovery in the long run.

A long-term medication or psychotherapy can be constantly needed for a couple of patients, based on the disorder and its severity. Nevertheless, a great majority of the patients with recurrent depression can finalize the medication successfully through a CBT treatment that is implemented alone or together with pharmacotherapy, and they can remain healthy for at least six years through a structured psychotherapy treatment.

REFERENCES:
Fava, G. A., Ruini C., Rafanelli, C., Finos, L., Conti, S., & Grandi, S. (2004). Six year outcome of cognitive behavior therapy for prevention of recurrent depression. The American Journal of Psychiatry, 161(10), 1872-1876.

Prof. Dr. Kemal Arıkan
Psychiatrist