Sudden gains and treatment outcomes among depressed individuals in a partial hospitalization programme

Abstract

Sudden gains commonly occur among patients receiving psychotherapy for depression and have been found to consistently predict better treatment outcomes. However, the majority of prior research has examined sudden gains primarily in weekly or biweekly treatment settings. Individuals were divided into two groups: those who experienced at least one sudden gain and those who did not. Rates of sudden gain occurrence, pretreatment factors and posttreatment outcomes were examined between the two groups. Over 60% of this sample experienced at least one sudden gain, the majority of which occurred during the first 3 days of treatment. Sudden gains were associated with significantly lower baseline depression and anxiety severity. Patients who experienced sudden gains reported significantly greater improvement in depressive and anxiety symptoms, coping skills, functioning, positive mental health and well‐being at treatment termination. This study was conducted in a single location with a relatively homogeneous sample. Due to a lack of follow‐up data, we were unable to determine if treatment outcomes were sustained after treatment termination. The assessment timeline of the depressive symptoms differs between baseline and daily scales, which may have affected the number of observed sudden gains after the initial treatment day. The proportion of sudden gains in this study is higher than those found in outpatient settings, demonstrating that this phenomenon may commonly occur among depressed patients in acute treatment. These results suggest that the mechanisms by which sudden gains occur may be reinforced by daily, intensive treatment.

Depression and suicide: What an evidence‐based clinician should know

“…Most studies have assessed the occurrence of sudden gains on a weekly or biweekly basis. In the article in this issue (Terrill et al, 2022 ), rates of sudden gain occurrence, pretreatment factors and posttreatment outcomes were examined in US patients who received daily, intensive therapy. Depressed patients who experienced sudden gains reported significantly greater improvement at the end of treatment, not only on depressive and anxiety symptoms but also in coping skills, functioning and positive mental health.…”