Enduring effects for cognitive behavior therapy in the treatment of depression and anxiety.

Recent studies suggest that cognitive and behavioral interventions have enduring effects that reduce risk for subsequent symptom return following treatment termination. These enduring effects have been most clearly demonstrated with respect to depression and the anxiety disorders. It remains unclear whether these effects are a consequence of the amelioration of the causal processes that generate risk or the introduction of compensatory strategies that offset them and whether these effects reflect the mobilization of cognitive or other mechanisms. No such enduring effects have been observed for the psychoactive medications, which appear to be largely palliative in nature. Other psychosocial interventions remain largely untested, although claims that they produce lasting change have long been made. Whether such enduring effects extend to other disorders remains to be seen, but the capacity to reduce risk following treatment termination is one of the major benefits provided by the cognitive and behavioral interventions with respect to the treatment of depression and the anxiety disorders.

[1]  D. Kupfer,et al.  Stressful life events and social rhythm disruption in the onset of manic and depressive bipolar episodes: a preliminary investigation. , 1998, Archives of general psychiatry.

[2]  W M Grove,et al.  Cognitive therapy and pharmacotherapy for depression. Singly and in combination. , 1992, Archives of general psychiatry.

[3]  G. Klerman,et al.  Depressed outpatients. Results one year after treatment with drugs and/or interpersonal psychotherapy. , 1981, Archives of general psychiatry.

[4]  M. Gelder,et al.  Exposure and anxiety management in the treatment of social phobia. , 1984, Journal of consulting and clinical psychology.

[5]  D. Klein,et al.  Cognitive‐behavioral group therapy versus phenelzine in social phobia: Long term outcome , 1999, Depression and anxiety.

[6]  R. DeRubeis,et al.  Sudden gains and critical sessions in cognitive-behavioral therapy for depression. , 1999, Journal of consulting and clinical psychology.

[7]  A. Swann,et al.  Cognitive-behavioral treatment of late-life generalized anxiety disorder. , 2003, Journal of consulting and clinical psychology.

[8]  M. Freeston,et al.  Efficacy of a cognitive-behavioral treatment for generalized anxiety disorder: evaluation in a controlled clinical trial. , 2000, Journal of consulting and clinical psychology.

[9]  T. Borkovec,et al.  Efficacy of applied relaxation and cognitive-behavioral therapy in the treatment of generalized anxiety disorder. , 1993, Journal of consulting and clinical psychology.

[10]  M. Keller,et al.  Patterns of remission and relapse in obsessive-compulsive disorder: a 2-year prospective study. , 1999, The Journal of clinical psychiatry.

[11]  J. Rosenbaum,et al.  Discontinuation of benzodiazepine treatment: efficacy of cognitive-behavioral therapy for patients with panic disorder. , 1993, The American journal of psychiatry.

[12]  D. Kupfer,et al.  Five-year outcome for maintenance therapies in recurrent depression. , 1990, Archives of general psychiatry.

[13]  Jack M. Gorman,et al.  A Guide to Treatments That Work , 2007 .

[14]  David K Ahern,et al.  Cognitive behavior therapy for hypochondriasis: a randomized controlled trial. , 2004, JAMA.

[15]  R. DeRubeis,et al.  Cognitive therapy vs medications in the treatment of moderate to severe depression. , 2005, Archives of general psychiatry.

[16]  D. Murphy,et al.  Return of symptoms after discontinuation of clomipramine in patients with obsessive-compulsive disorder. , 1988, The American journal of psychiatry.

[17]  R. Bradley,et al.  A multidimensional meta-analysis of psychotherapy for PTSD. , 2005, The American journal of psychiatry.

[18]  A. Simons,et al.  The process of change in cognitive therapy and pharmacotherapy for depression. Changes in mood and cognition. , 1984, Archives of general psychiatry.

[19]  Cognitive-behavior therapy versus pharmacotherapy: Now that the jury's returned its verdict, it's time to present the rest of the evidence. , 1996 .

[20]  I. Blackburn,et al.  A two-year naturalistic follow-up of depressed patients treated with cognitive therapy, pharmacotherapy and a combination of both. , 1986, Journal of affective disorders.

[21]  N. Tarrier,et al.  A randomized trial of cognitive therapy and imaginal exposure in the treatment of chronic posttraumatic stress disorder. , 1999, Journal of consulting and clinical psychology.

[22]  D J Kupfer,et al.  Three-year outcomes for maintenance therapies in recurrent depression. , 1990, Archives of general psychiatry.

[23]  P. Resick,et al.  Cognitive processing therapy for sexual assault victims. , 1992, Journal of consulting and clinical psychology.

[24]  R. DeRubeis,et al.  On second thought: Where the action is in cognitive therapy for depression , 1989, Cognitive Therapy and Research.

[25]  D. Klein Preventing hung juries about therapy studies. , 1996, Journal of consulting and clinical psychology.

[26]  M. Shea,et al.  Course of depressive symptoms over follow-up. Findings from the National Institute of Mental Health Treatment of Depression Collaborative Research Program. , 1992, Archives of general psychiatry.

[27]  Robert Ladouceur,et al.  Group cognitive-behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up. , 2003, Journal of consulting and clinical psychology.

[28]  W M Grove,et al.  How does cognitive therapy work? Cognitive change and symptom change in cognitive therapy and pharmacotherapy for depression. , 1990, Journal of consulting and clinical psychology.

[29]  Lars-Göran Öst,et al.  Applied relaxation vs cognitive behavior therapy in the treatment of panic disorder. , 1995, Behaviour research and therapy.

[30]  J. Geller,et al.  What Works for Whom? A Critical Review of Psychotherapy Research , 1997 .

[31]  D H Barlow,et al.  Advances in the psychosocial treatment of anxiety disorders. Implications for national health care. , 1996, Archives of general psychiatry.

[32]  I. Holme,et al.  Randomised controlled general practice trial of sertraline, exposure therapy and combined treatment in generalised social phobia , 2001, British Journal of Psychiatry.

[33]  D. Clark A cognitive approach to panic. , 1986, Behaviour research and therapy.

[34]  M. Kozak,et al.  Randomized, placebo-controlled trial of exposure and ritual prevention, clomipramine, and their combination in the treatment of obsessive-compulsive disorder. , 2007, The American journal of psychiatry.

[35]  A. Simons,et al.  The Process of Change in Cognitive Therapy and Pharmacotherapy for Depression , 1984 .

[36]  N. Tarrier,et al.  Randomised controlled trial of efficacy of teaching patients with bipolar disorder to identify early symptoms of relapse and obtain treatment , 1999, BMJ.

[37]  A. Beck Cognitive therapy: A 30-year retrospective. , 1991 .

[38]  G. Ironson,et al.  Comparison of two treatments for traumatic stress: a community-based study of EMDR and prolonged exposure. , 2002, Journal of clinical psychology.

[39]  B. Rothbaum,et al.  Treatment of posttraumatic stress disorder in rape victims: a comparison between cognitive-behavioral procedures and counseling. , 1991, Journal of consulting and clinical psychology.

[40]  J. Gillham,et al.  Preventing depression: A review of cognitive-behavioral and family interventions , 2000 .

[41]  L. Salmaso,et al.  Well-Being Therapy of Generalized Anxiety Disorder , 2004, Psychotherapy and Psychosomatics.

[42]  R. Tamura,et al.  Long-Term Treatment of Obsessive-Compulsive Disorder After an Acute Response: A Comparison of Fluoxetine Versus Placebo , 2001, Journal of clinical psychopharmacology.

[43]  A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims. , 1999 .

[44]  N. Jacobson,et al.  A component analysis of cognitive-behavioral treatment for depression. , 1996, Journal of consulting and clinical psychology.

[45]  A. Pincus,et al.  A component analysis of cognitive-behavioral therapy for generalized anxiety disorder and the role of interpersonal problems. , 2002, Journal of consulting and clinical psychology.

[46]  John C. Markowitz,et al.  Treatment and Prevention of Depression , 2002, Psychological science in the public interest : a journal of the American Psychological Society.

[47]  David C. Atkins,et al.  Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. , 2006, Journal of consulting and clinical psychology.

[48]  J. Davidson,et al.  The epidemiology of social phobia: findings from the Duke Epidemiological Catchment Area Study , 1993, Psychological Medicine.

[49]  P. Sham,et al.  A randomized controlled study of cognitive therapy for relapse prevention for bipolar affective disorder: outcome of the first year. , 2003, Archives of general psychiatry.

[50]  A. Harvey,et al.  Treatment of acute stress disorder: a comparison of cognitive-behavioral therapy and supportive counseling. , 1998, Journal of consulting and clinical psychology.

[51]  M. Fava,et al.  Effects of Adding Cognitive Therapy to Fluoxetine Dose Increase on Risk of Relapse and Residual Depressive Symptoms in Continuation Treatment of Major Depressive Disorder , 2002, Journal of clinical psychopharmacology.

[52]  J. Price Anxiety Disorders and Phobias. A Cognitive Perspective . By Aaron T. Beck and Gary Emery. (Basic Books, New York, 1985.) , 1986, Journal of Biosocial Science.

[53]  Steven Taylor,et al.  Comparative efficacy, speed, and adverse effects of three PTSD treatments: exposure therapy, EMDR, and relaxation training. , 2003, Journal of consulting and clinical psychology.

[54]  P. Salkovskis,et al.  A Controlled Trial of Cognitive–Behavioural Treatment of Hypochondriasis , 1996, British Journal of Psychiatry.

[55]  R. DeRubeis,et al.  Prevention of relapse following cognitive therapy vs medications in moderate to severe depression. , 2005, Archives of general psychiatry.

[56]  P. Crits-Christoph,et al.  Prevention of recurrent depression with cognitive behavioral therapy. , 1999, Archives of general psychiatry.

[57]  P. Salkovskis,et al.  The effect of one-session treatment for spider phobia on attentional bias and beliefs. , 1997, The British journal of clinical psychology.

[58]  Nicole Thibodeau,et al.  Specificity of generalized anxiety disorder symptoms and processes , 1999 .

[59]  R. DeRubeis,et al.  Empirically supported individual and group psychological treatments for adult mental disorders. , 1998, Journal of consulting and clinical psychology.

[60]  M. Seligman,et al.  The prevention of depression and anxiety. , 1999 .

[61]  Lars-Göran Öst,et al.  One versus five sessions of applied tension in the treatment of blood phobia. , 1996, Behaviour research and therapy.

[62]  A. Bandura Self-efficacy: toward a unifying theory of behavioral change. , 1977, Psychological review.

[63]  M. Hegel,et al.  Cognitive-behavioral therapy helps prevent relapse and recurrence of panic disorder following alprazolam discontinuation: a long-term follow-up of the Peoria and Dartmouth studies. , 1999, Journal of consulting and clinical psychology.

[64]  J. Richards,et al.  A randomized study of family-focused psychoeducation and pharmacotherapy in the outpatient management of bipolar disorder. , 2003, Archives of general psychiatry.

[65]  S. Taylor,et al.  Cognitive versus behavior therapy in the group treatment of obsessive-compulsive disorder. , 2001, Journal of consulting and clinical psychology.

[66]  H. Warwick,et al.  Hypochondriasis. , 1990, Behaviour research and therapy.

[67]  Laura L. Vernon,et al.  Changes in caffeine states enhance return of fear in spider phobia. , 2003, Journal of consulting and clinical psychology.

[68]  M. Freeston,et al.  Cognitive-behavioral treatment of obsessive thoughts: a controlled study. , 1997, Journal of consulting and clinical psychology.

[69]  M. Kozak,et al.  Long-Term Efficacy of Exposure and Ritual Prevention Therapy and Serotonergic Medications for Obsessive-Compulsive Disorder , 2003, CNS Spectrums.

[70]  P. Sham,et al.  Relapse prevention in patients with bipolar disorder: cognitive therapy outcome after 2 years. , 2005, The American journal of psychiatry.

[71]  S. Woods,et al.  Differential response to placebo among patients with social phobia, panic disorder, and obsessive-compulsive disorder. , 2004, The American journal of psychiatry.

[72]  G. Klerman,et al.  Treatment of depression by drugs and psychotherapy. , 1974, The American journal of psychiatry.

[73]  Richard G. Heimberg,et al.  Cognitive—behavioral group treatment for social phobia: Effectiveness at five-year followup , 1993, Cognitive Therapy and Research.

[74]  R. DeRubeis,et al.  The temporal relation of adherence and alliance to symptom change in cognitive therapy for depression. , 1999, Journal of consulting and clinical psychology.

[75]  D. Robinson,et al.  Efficacy of sertraline in the long-term treatment of obsessive-compulsive disorder. , 2002, The American journal of psychiatry.

[76]  D J Kupfer,et al.  Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence. , 1991, Archives of general psychiatry.

[77]  G. Fava,et al.  Prevention of recurrent depression with cognitive behavioral therapy: preliminary findings. , 1998, Archives of general psychiatry.

[78]  P. Salkovskis,et al.  Social Phobia: The Role of In-Situation Safety Behaviors in Maintaining Anxiety and Negative Beliefs , 1995 .

[79]  J. Davidson,et al.  Social anxiety disorder in review: two decades of progress. , 2001, The international journal of neuropsychopharmacology.

[80]  T. Furmark,et al.  One-session group therapy of spider phobia: direct versus indirect treatments. , 1997, Behaviour research and therapy.

[81]  N. Jacobson,et al.  Behavioral Activation Treatment for Depression: Returning to Contextual Roots , 2006 .

[82]  A. Ehlers,et al.  Psychological debriefing for road traffic accident victims , 2000, British Journal of Psychiatry.

[83]  R. DeRubeis,et al.  The temporal relation of adherence and alliance to symptom change in cognitive therapy for depression. , 1999, Journal of consulting and clinical psychology.

[84]  D. Clark,et al.  A cognitive model of posttraumatic stress disorder. , 2000, Behaviour research and therapy.

[85]  J. Seeley,et al.  A randomized trial of a group cognitive intervention for preventing depression in adolescent offspring of depressed parents. , 2001, Archives of general psychiatry.

[86]  M. Hautzinger,et al.  Randomised placebo-controlled trial of moclobemide, cognitive–behavioural therapy and their combination in panic disorder with agoraphobia , 1999, British Journal of Psychiatry.

[87]  A. V. van Balkom,et al.  Cognitive therapy and exposure in vivo in the treatment of obsessive compulsive disorder. , 1995, Behaviour research and therapy.

[88]  J. Greenhouse,et al.  An introduction to survival analysis: statistical methods for analysis of clinical trial data. , 1989, Journal of consulting and clinical psychology.

[89]  M. Seligman,et al.  Cognitive therapy and the prevention of depression , 1992 .

[90]  A. Simons,et al.  Cognitive therapy and pharmacotherapy for depression. Sustained improvement over one year. , 1986, Archives of general psychiatry.

[91]  M. Kozak,et al.  Psychological treatment for obsessive-compulsive disorder. , 1996 .

[92]  P. Salkovskis,et al.  Multiple pathways to inflated responsibility beliefs in obsessional problems: possible origins and implications for therapy and research. , 1999, Behaviour research and therapy.

[93]  K. Power,et al.  Fluvoxamine, placebo, and cognitive behaviour therapy used alone and in combination in the treatment of panic disorder and agoraphobia , 1996 .

[94]  D. Clark,et al.  Cognitive therapy versus fluoxetine in generalized social phobia: a randomized placebo-controlled trial. , 2003, Journal of consulting and clinical psychology.

[95]  J. Teasdale,et al.  Prevention of relapse in residual depression by cognitive therapy: a controlled trial. , 1999, Archives of general psychiatry.

[96]  A. Beck,et al.  Anxiety disorders and phobias : a cognitive perspective , 2005 .

[97]  R. DeRubeis,et al.  Cognitive Mediation of Relapse Prevention Following Treatment for Depression: Implications of Differential Risk , 1990 .

[98]  R. DeRubeis,et al.  Differential relapse following cognitive therapy and pharmacotherapy for depression. , 1992, Archives of general psychiatry.

[99]  J. Singer,et al.  Investigating onset, cessation, relapse, and recovery: why you should, and how you can, use discrete-time survival analysis to examine event occurrence. , 1993, Journal of consulting and clinical psychology.

[100]  K. Dobson,et al.  Cognitive therapy of depression: pretreatment patient predictors of outcome. , 2002, Clinical psychology review.

[101]  I. Holme,et al.  Exposure therapy and sertraline in social phobia: 1-year follow-up of a randomised controlled trial , 2003, British Journal of Psychiatry.

[102]  P. Lelliott,et al.  Alprazolam and Exposure Alone and Combined in Panic Disorder with Agoraphobia , 1993, British Journal of Psychiatry.

[103]  Ann Hackmann,et al.  A randomized controlled trial of cognitive therapy, a self-help booklet, and repeated assessments as early interventions for posttraumatic stress disorder. , 2003, Archives of general psychiatry.

[104]  M. Shea,et al.  Mode-specific effects among three treatments for depression. , 1990, Journal of consulting and clinical psychology.

[105]  A. M. Ruscio,et al.  Psychotherapy for generalized anxiety disorder. , 2001, The Journal of clinical psychiatry.

[106]  J. Teasdale,et al.  How Does Cognitive Therapy Prevent Relapse in Residual Depression ? Evidence From a Controlled Trial , 2001 .

[107]  S. Bouchard,et al.  Exposure versus cognitive restructuring in the treatment of panic disorder with agoraphobia. , 1996, Behaviour research and therapy.

[108]  J. Willett,et al.  Using growth modeling to examine systematic differences in growth: an example of change in the functioning of families at risk of maladaptive parenting, child abuse, or neglect. , 1991, Journal of consulting and clinical psychology.

[109]  M. Liebowitz,et al.  The empirical basis of generalized anxiety disorder. , 1994, The American journal of psychiatry.

[110]  R. DeRubeis,et al.  Determinants of change in cognitive therapy for depression , 1990, Cognitive Therapy and Research.

[111]  M. Seligman,et al.  Prevention of depressive symptoms in school children. , 1994, Behaviour research and therapy.

[112]  J. Kane,et al.  Extending indications for long-term pharmacotherapy: opportunities and challenges. , 2002, The American journal of psychiatry.

[113]  T. Heidenreich,et al.  Cognitive therapy for social phobia: individual versus group treatment. , 2003, Behaviour research and therapy.

[114]  W. Hawkins,et al.  Targeted prevention of unipolar depressive disorder in an at-risk sample of high school adolescents: a randomized trial of a group cognitive intervention. , 1995, Journal of the American Academy of Child and Adolescent Psychiatry.

[115]  G. Klerman,et al.  Interpersonal psychotherapy of depression , 1984 .

[116]  S D Imber,et al.  Some conceptual and statistical issues in analysis of longitudinal psychiatric data. Application to the NIMH treatment of Depression Collaborative Research Program dataset. , 1993, Archives of general psychiatry.

[117]  L. Price,et al.  A 40-year follow-up of patients with obsessive compulsive disorder , 2002, European Psychiatry.

[118]  Steven V. Marcus,et al.  Controlled study of treatment of PTSD using EMDR in an HMO setting. , 1997 .

[119]  S. Hollon,et al.  Prospects for future comparisons between drugs and psychotherapy: lessons from the CBT-versus-pharmacotherapy exchange. , 1996, Journal of consulting and clinical psychology.

[120]  P. Salkovskis,et al.  A Comparison of Cognitive Therapy, Applied Relaxation and Imipramine in the Treatment of Panic Disorder , 1994, British Journal of Psychiatry.

[121]  D. Klein,et al.  Cognitive behavioral group therapy vs phenelzine therapy for social phobia: 12-week outcome. , 1998, Archives of general psychiatry.

[122]  P. Salkovskis Understanding and treating obsessive-compulsive disorder. , 1999, Behaviour research and therapy.

[123]  N. Jacobson,et al.  Reasons for depression and the process and outcome of cognitive-behavioral psychotherapies. , 1996, Journal of consulting and clinical psychology.

[124]  Z. Segal,et al.  Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. , 2000, Journal of consulting and clinical psychology.

[125]  S. Spence,et al.  The relative efficacy and treatment distress of EMDR and a cognitive-behavior trauma treatment protocol in the amelioration of posttraumatic stress disorder. , 1999, Journal of anxiety disorders.

[126]  P. Nishith,et al.  A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. , 2002, Journal of consulting and clinical psychology.

[127]  G. Fava,et al.  Long-term outcome of social phobia treated by exposure , 2001, Psychological Medicine.

[128]  Lars-Göran Öst,et al.  One-session therapist directed exposure vs two forms of manual directed self-exposure in the treatment of spider phobia. , 1995, Behaviour research and therapy.

[129]  G. Maina,et al.  Drug treatment of obsessive-compulsive disorder (OCD): long-term trial with clomipramine and selective serotonin reuptake inhibitors (SSRIs). , 1996, Psychopharmacology bulletin.

[130]  S. Hollon,et al.  Cognitive and cognitive-behavioral therapies. , 1994 .

[131]  J. McClellan,et al.  Practice guideline for the treatment of patients with bipolar disorder , 1994 .

[132]  S. Hollon,et al.  Depressed outpatients treated with cognitive therapy or pharmacotherapy. A one-year follow-up. , 1981, Archives of general psychiatry.

[133]  N. Jacobson,et al.  Cognitive-behavioral treatment for depression: relapse prevention. , 1998, Journal of consulting and clinical psychology.

[134]  G. Sartory,et al.  Comparison between one-session psychological treatment and benzodiazepine in dental phobia. , 2000, Journal of consulting and clinical psychology.

[135]  L. A. Becker,et al.  Fifteen-month follow-up of eye movement desensitization and reprocessing (EMDR) treatment for posttraumatic stress disorder and psychological trauma. , 1997, Journal of consulting and clinical psychology.

[136]  J. Markowitz,et al.  Background information and treatment recommendations for patients with HIV/AIDS , 2000 .

[137]  M. Kozak,et al.  Post‐treatment effects of exposure therapy and clomipramine in obsessive–compulsive disorder , 2004, Depression and anxiety.

[138]  Kamryn T. Eddy,et al.  A multidimensional meta-analysis of psychotherapy and pharmacotherapy for obsessive-compulsive disorder. , 2004, Clinical psychology review.

[139]  O. Mowrer Learning theory and the neurotic paradox. , 1948, The American journal of orthopsychiatry.

[140]  A. Arntz,et al.  Psychological treatments of panic disorder without agoraphobia: cognitive therapy versus applied relaxation. , 1996, Behaviour research and therapy.

[141]  M K Shear,et al.  Cognitive-behavioral therapy, imipramine, or their combination for panic disorder: A randomized controlled trial. , 2000, JAMA.

[142]  O. Brawman‐Mintzer,et al.  Recent developments in the psychopharmacology of anxiety disorders. , 1996 .

[143]  I. Marks,et al.  Enhanced Relief of Phobias by Flooding During Waning Diazepam Effect , 1972, British Journal of Psychiatry.

[144]  K. Power,et al.  Does cognitive-behavioural therapy influence the long-term outcome of generalized anxiety disorder? An 8–14 year follow-up of two clinical trials , 2003, Psychological Medicine.

[145]  P. Salkovskis,et al.  Two psychological treatments for hypochondriasis , 1998, British Journal of Psychiatry.

[146]  P. A. Vogel,et al.  ADDING COGNITIVE THERAPY ELEMENTS TO EXPOSURE THERAPY FOR OBSESSIVE COMPULSIVE DISORDER: A CONTROLLED STUDY , 2004, Behavioural and Cognitive Psychotherapy.

[147]  K. Lovell,et al.  Treatment of posttraumatic stress disorder by exposure and/or cognitive restructuring: a controlled study. , 1998, Archives of general psychiatry.

[148]  M. Bouton Context, time, and memory retrieval in the interference paradigms of Pavlovian learning. , 1993, Psychological bulletin.

[149]  D. Nutt,et al.  Consensus statement update on posttraumatic stress disorder from the international consensus group on depression and anxiety. , 2004, The Journal of clinical psychiatry.

[150]  L A Becker,et al.  Eye movement desensitization and reprocessing (EMDR) treatment for psychologically traumatized individuals. , 1995, Journal of consulting and clinical psychology.