Introduction: Major depressive disorder (MDD) is common, and recurrence rates are high. Preventive Cognitive Therapy (PCT), has been shown to prolong time to recurrence and reduce risk of recurrence(s) over 2–10 years in patients with recurrent depression. Objective: The aim of the study was to examine the effectiveness of PCT over 20 years on time to first recurrence, cumulative proportion of first recurrences, percentage of depression-free time, mean severity of recurrences, and the number of recurrences within a patient. Methods: Adults remitted from recurrent MDD were randomized to PCT or Treatment As Usual (TAU). Clinical outcomes were assessed using the SCID over 20 years. We used Cox regression analyses, Kaplan-Meier analyses, ANOVA, and negative binomial regression and tested for interaction with the number of previous episodes. Results: There was a significant interaction effect for number of previous episodes with treatment condition on time to first recurrence (Wald[1, n = 172] = 8.840, p = 0.003). For participants with more than 3 previous episodes, the mean time to recurrence was 4.8 years for PCT versus 1.6 years for TAU; the cumulative proportion of first recurrences was 87.5% for PCT and 100% for TAU. For participants with more than 3 previous episodes, exploratory analyses suggest that PCT had 53% less recurrences and percentage of depression-free time was significantly higher compared to TAU. There were no significant effects on mean severity. Conclusions: Up to 20 years, for MDD patients with more than 3 previous episodes, those who received PCT had significantly longer time to a first recurrence and lower recurrence risk and may have less recurrences and more depression-free time compared to TAU. This suggests long term protective effects of PCT up to 20-years.
Psychother Psychosom

中文翻译：

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预防性认知疗法对复发性抑郁症缓解的成人长达 20 年的随访效果：DELTA 研究

简介：重度抑郁症 (MDD) 很常见，而且复发率很高。预防性认知疗法 (PCT) 已被证明可以延长复发时间并降低复发性抑郁症患者 2-10 年的复发风险。目的：该研究的目的是检查 PCT 在 20 年内对首次复发的时间、首次复发的累积比例、无抑郁时间的百分比、复发的平均严重程度以及患者的复发次数的有效性。方法：从复发性 MDD 缓解的成年人被随机分配到 PCT 或照常治疗 (TAU)。使用 SCID 评估了 20 年的临床结果。我们使用了 Cox 回归分析、Kaplan-Meier 分析、方差分析和负二项式回归，并测试了与之前发作次数的交互作用。结果：先前发作的次数与治疗条件对第一次复发的时间有显着的交互作用 (Wald[1, n = 172] = 8.840, p= 0.003）。对于先前发作超过 3 次的参与者，PCT 的平均复发时间为 4.8 年，而 TAU 为 1.6 年；PCT首次复发的累积比例为87.5%，TAU为100%。对于先前发作超过 3 次的参与者，探索性分析表明，与 TAU 相比，PCT 的复发率降低了 53%，并且无抑郁时间的百分比明显更高。对平均严重程度没有显着影响。结论：长达 20 年，对于既往发作超过 3 次的 MDD 患者，与 TAU 相比，接受 PCT 的患者首次复发的时间明显更长，复发风险更低，复发更少，无抑郁时间更长。这表明 PCT 的长期保护作用长达 20 年。
心理医生