Long term outcome of primary care depression

Yiend, Jenny; Paykel, Eugene S.; Merritt, Rowena; Lester, Kathryn J.; Doll, Helen; Burns, Tom

doi:10.1016/j.jad.2009.01.026

Cited by 59 publications

(40 citation statements)

References 26 publications

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Section: Considerations For Policy and Practicesupporting

confidence: 90%

“…Current mental health policy in the UK emphasises the notion of recovery (Department of Health, 2014), reinforcing a short-term view about common mental health problems in primary care. Our findings align with the extant literature (Burcusa & Iacono, 2007;Yiend et al, 2009;Harter et al, 2007;Hardeveld et al, 2010;Gopinath et al, 2007) and suggest taking the long view, recognising that 19 problems like depression often have to be managed like recurrent long-term conditions.In this regard, we would recommend two areas for future practice developments. First, the influence of residual depression symptoms on the risk of relapse is well documented (Vittengl et al, 2007;Paykel et al, 1995), and it is known that around 76% of such cases relapse within 10 months of treatment completion (Paykel, 2008).…”

supporting

confidence: 90%

“…Depression is known to have a high recurrence rate, even after the successful treatment of acute-phase symptoms (Burcusa & Iacono, 2007;Yiend et al, 2009;Harter et al, 2007;Hardeveld et al, 2010;Gopinath et al, 2007). For example, after a first episode of depression, the probability of a further episode is approximately 50%; this rises to 70% following two episodes and 90% after a third episode (Burcusa & Iacono, 2007;Kessler et al, 1996).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Ali

Rhodes

Moreea

et al. 2017

Behaviour Research and Therapy

108

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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 3 IntroductionDepression is known to have a high recurrence rate, even after the successful treatment of acute-phase symptoms (Burcusa & Iacono, 2007;Yiend et al., 2009;Harter et al., 2007;Hardeveld et al., 2010;Gopinath et al., 2007). For example, after a first episode of depression, the probability of a further episode is approximately 50%; this rises to 70% following two episodes and 90% after a third episode (Burcusa & Iacono, 2007;Kessler et al., 1996). It also appears that with each further episode there is an increase in the severity of depressive symptoms and an increased probability that these symptoms will become resistant to treatment (Kendler et al., 2000).Similarly, research on anxiety disorders suggests high recurrence rates between 39% and 56% after treatment (Bruce et al., 2005;Eisen et al., 1999;Vervliet et al., 2013).Literature in the field draws conceptual distinctions between relapsea deterioration after initial response to treatment-and recurrence -a new episode of the disorder following a period of recovery- (Bockting et al., 2015).Meta-analyses of trials in this area show that accessing cognitive behavioural therapy (CBT) reduces the risk of depression relapse (Vittengl et al., 2007; Cuijpers et al., 2013) by comparison to acute-phase pharmacological treatment. The prophylactic effects of CBT appear to be as durable as to those of long-term maintenance on pharmacological treatment, but better at preventing relapse and recurrence compared to acute-phase pharmacological treatment without a maintenance phase (Hollon et al., 2005). Similarly, CBT is associated with sustained maintenance of improvements after the acute phase of treatment in various anxiety disorders (Otto, Smits, & Reese, 2005). It is, however, unclear if this 4 apparent durability of therapeutic effects primarily applies to conventi...

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Section: Considerations For Policy and Practicesupporting

confidence: 90%

supporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Ali

Rhodes

Moreea

et al. 2017

Behaviour Research and Therapy

108

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“…In addition the long term outcome of depression treated in primary care is worse than previously thought (Yiend et al, 2009) suggesting that developing new, low cost, widely accessible and effective interventions for depression is an increasing priority for services.…”

Section: Effects Of Prospective Cognition On Cognitive Bias Modificatmentioning

confidence: 99%

How can we enhance cognitive bias modification techniques? The effects of prospective cognition

Lee

Mathews

Shergill

et al. 2015

Journal of Behavior Therapy and Experimental Psychiatry

Self Cite

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Results: Significant differences between enhanced and standard CBM-errors revealed that enhanced positive training was more effective at decreasing negative interpretations compared to the standard procedure.Limitations: Extending the current investigation to a sample dysphoria or depression is needed for an appropriate next step. Conclusion:The findings serve as 'a proof of principle' for the potential of prospective cognition to enhance the effects of CBM-errors and other similar CBM procedures. Further work to enhance the effectiveness of CBM procedures is needed.

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“…However, many studies are now showing that patients with TRD have poor outcomes to traditional medication treatment (Fekadu et al, 2009;Rhebergen et al, 2009;Rush et al, 2006a, b;Ten Doesschate et al, 2009;Trivedi et al, 2006;Yiend et al, 2009). Attempts to predict who is more likely to respond to VNS have not been successful.…”

Section: Clinical Studiesmentioning

confidence: 99%

Noninvasive techniques for probing neurocircuitry and treating illness: vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS)

George

Aston‐Jones

2009

Neuropsychopharmacol

319

205

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Although the preceding chapters discuss much of the new knowledge of neurocircuitry of neuropsychiatric diseases, and an invasive approach to treatment, this chapter describes and reviews the noninvasive methods of testing circuit-based theories and treating neuropsychiatric diseases that do not involve implanting electrodes into the brain or on its surface. These techniques are transcranial magnetic stimulation, vagus nerve stimulation, and transcranial direct current stimulation. Two of these approaches have FDA approval as therapies.

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Long term outcome of primary care depression

Cited by 59 publications

References 26 publications

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

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

How can we enhance cognitive bias modification techniques? The effects of prospective cognition

Noninvasive techniques for probing neurocircuitry and treating illness: vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS)

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