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Preventie van terugval bij recidiverende depressie met cognitieve therapie
Samenvatting
Dit artikel rapporteert de uitkomsten van een gerandomiseerd gecontroleerdestudie naar cognitieve therapie (CT) ter preventie van terugval bijeen groep dat een zeer hoog risico loopt op terugval, namelijk patiënten met recidiverende depressies. De patiënten met recidiverende depressies (N = 187), die huidig in remissie zijn na het volgen van verschillende behandelingen, werden willekeurig toegewezen aan ofwel reguliere zorg, inclusief het continueren van voorgeschreven psychofarmaca, ofwel aan reguliere zorg aangevuld met kortdurende CT. Gedurende twee jaar werd depressieve terugval (‘major depressive episode') bepaald. De aanvulling van CT aan de reguliere zorg resulteerde in een significant beschermend effect, dat effect intensifieerde naarmate er meer voorafgaande depressieve episodes waren geweest. Voor patiënten met 5 of meer eerdere episodes (41% van de steekproef), reduceerde CT de kans op terugval van 72% naar 46%. Onze bevindingen verbreden de bestaande evidentie dat cognitieve interventies tijdens remissie nuttig kunnen zijn in het voorkomen van terugval bij patiënten met recidiverende depressie.
Summary
Relapse prevention in recurrent depression with cognitive therapy
This paper reports on the outcome of a randomized controlled trial of cognitive group therapy (CT) to prevent relapse/recurrence in a group of high-risk patients diagnosed with recurrent depression. Recurrently depressed patients ( N = 187) currently in remission following various types of treatment were randomized to treatment as usual, including continuation of pharmacotherapy, or to treatment as usual augmented with brief CT. Relapse/recurrence to major depression was assessed over 2 years. Augmenting treatment as usual with CT resulted in a significant protective effect, which intensified with the number of previous depressive episodes experienced. For patients with 5 or more previous episodes (41% of the sample), CT reduced relapse/recurrence from 72% to 46%. Our findings extend the accumulating evidence that cognitive interventions following remission can be useful in preventing relapse/recurrence in patients with recurrent depression.
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