A prognostic index for long-term outcome after successful acute phase cognitive therapy and interpersonal psychotherapy for major depressive disorder

Suzanne C. van Bronswijk, Lotte H.J.M. Lemmens, John R. Keefe, Marcus J.H. Huibers, Robert J. DeRubeis, Frenk P.M.L. Peeters

Research output: Contribution to JournalArticleAcademicpeer-review

Abstract

Background: Major depressive disorder (MDD) has a highly recurrent nature. After successful treatment, it is important to identify individuals who are at risk of an unfavorable long-term course. Despite extensive research, there is no consensus yet on the clinically relevant predictors of long-term outcome in MDD, and no prediction models are implemented in clinical practice. The aim of this study was to create a prognostic index (PI) to estimate long-term depression severity after successful and high quality acute treatment for MDD. Methods: Data come from responders to cognitive therapy (CT) and interpersonal psychotherapy (IPT) in a randomized clinical trial (n = 85; CT = 45, IPT = 40). Primary outcome was depression severity, assessed with the Beck Depression Inventory II, measured throughout a 17-month follow-up phase. We examined 29 variables as potential predictors, using a model-based recursive partitioning method and bootstrap resampling in conjunction with backwards elimination. The selected predictors were combined into a PI. Individual PI scores were estimated using a cross-validation approach. Results: A total of three post-treatment predictors were identified: depression severity, hopelessness, and self-esteem. Cross-validated PI scores evidenced a strong correlation (r = 0.60) with follow-up depression severity. Conclusion: Long-term predictions of MDD are multifactorial, involving a combination of variables that each has a small prognostic effect. If replicated and validated, the PI can be implemented to predict follow-up depression severity for each individual after acute treatment response, and to personalize long-term treatment strategies.

LanguageEnglish
Pages252-261
Number of pages10
JournalDepression and Anxiety
Volume36
Issue number3
Early online date5 Dec 2018
DOIs
Publication statusPublished - Mar 2019

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Major Depressive Disorder
Cognitive Therapy
Psychotherapy
Depression
Self Concept
Consensus
Randomized Controlled Trials
Equipment and Supplies
Research

Keywords

  • clinical trials
  • cognitive therapy
  • depression
  • empirical supported treatments
  • interpersonal psychotherapy

Cite this

van Bronswijk, Suzanne C. ; Lemmens, Lotte H.J.M. ; Keefe, John R. ; Huibers, Marcus J.H. ; DeRubeis, Robert J. ; Peeters, Frenk P.M.L. / A prognostic index for long-term outcome after successful acute phase cognitive therapy and interpersonal psychotherapy for major depressive disorder. In: Depression and Anxiety. 2019 ; Vol. 36, No. 3. pp. 252-261.
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A prognostic index for long-term outcome after successful acute phase cognitive therapy and interpersonal psychotherapy for major depressive disorder. / van Bronswijk, Suzanne C.; Lemmens, Lotte H.J.M.; Keefe, John R.; Huibers, Marcus J.H.; DeRubeis, Robert J.; Peeters, Frenk P.M.L.

In: Depression and Anxiety, Vol. 36, No. 3, 03.2019, p. 252-261.

Research output: Contribution to JournalArticleAcademicpeer-review

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AU - Keefe, John R.

AU - Huibers, Marcus J.H.

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