How durable is the effect of low intensity CBT for depression and anxiety? Remission and relapse in a longitudinal cohort study

TY - JOUR

T1 - How durable is the effect of low intensity CBT for depression and anxiety?

T2 - Remission and relapse in a longitudinal cohort study

AU - Ali, Shehzad

AU - Rhodes, Laura

AU - Moreea, Omar

AU - McMillan, Dean

AU - Gilbody, Simon Martin

AU - Leach, Chris

AU - Lucock, Mike

AU - Lutz, Wolfgang

AU - Delgadillo, Jaime

N1 - © Elseveier Ltd., 2017. This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy.

PY - 2017/7

Y1 - 2017/7

N2 - Background: Depression and anxiety disorders are relapse-prone conditions, even after successful treatment with pharmacotherapy or psychotherapy. Cognitive behavioural therapy (CBT) is known to prevent relapse, but there is little evidence of the durability of remission after low intensity forms of CBT (LiCBT). Method: This study aimed to examine relapse rates 12 months after completing routinely-delivered LiCBT. A cohort of 439 LiCBT completers with remission of symptoms provided monthly depression (PHQ-9) and anxiety (GAD-7) measures during 12 months after treatment. Survival analysis was conducted to model time-to-relapse while controlling for patient characteristics. Results: Overall, 53% of cases relapsed within 1 year. Of these relapse events, the majority (79%) occurred within the first 6 months posttreatment. Cases reporting residual depression symptoms (PHQ-9 = 5 to 9) at the end of treatment had significantly higher risk of relapse (hazard ratio = 1.90, p < 0.001). Conclusions: The high rate of relapse after LiCBT highlights the need for relapse prevention, particularly for those with residual depression symptoms. Key words: depression; anxiety; relapse; cognitive behavioural therapy

AB - Background: Depression and anxiety disorders are relapse-prone conditions, even after successful treatment with pharmacotherapy or psychotherapy. Cognitive behavioural therapy (CBT) is known to prevent relapse, but there is little evidence of the durability of remission after low intensity forms of CBT (LiCBT). Method: This study aimed to examine relapse rates 12 months after completing routinely-delivered LiCBT. A cohort of 439 LiCBT completers with remission of symptoms provided monthly depression (PHQ-9) and anxiety (GAD-7) measures during 12 months after treatment. Survival analysis was conducted to model time-to-relapse while controlling for patient characteristics. Results: Overall, 53% of cases relapsed within 1 year. Of these relapse events, the majority (79%) occurred within the first 6 months posttreatment. Cases reporting residual depression symptoms (PHQ-9 = 5 to 9) at the end of treatment had significantly higher risk of relapse (hazard ratio = 1.90, p < 0.001). Conclusions: The high rate of relapse after LiCBT highlights the need for relapse prevention, particularly for those with residual depression symptoms. Key words: depression; anxiety; relapse; cognitive behavioural therapy

U2 - 10.1016/j.brat.2017.04.006

DO - 10.1016/j.brat.2017.04.006

M3 - Article

SN - 0005-7967

VL - 94

SP - 1

EP - 8

JO - Behaviour research and therapy

JF - Behaviour research and therapy

ER -