Jarrett R B, Basco M R, Risser R, Ramanan J, Marwill M, Kraft D, Rush A J
Department of Psychiatry, University of Texas Southwestern Medical Center at Dallas 75235-9149, USA.
J Consult Clin Psychol. 1998 Dec;66(6):1036-40. doi: 10.1037//0022-006x.66.6.1036.
Two pilot studies evaluated the rate of relapse or recurrence (i.e., major depressive disorder) after cognitive therapy (CT). Two sequential cohorts included outpatients who responded to acute phase CT (A-CT) and who agreed to monthly, treatment-free follow-up. In Study 1, the Kaplan-Meier technique estimated relapse and recurrence rates of 40% at 6 months, 45% at 8 months, 50% at 12 months, 67% at 18 months, and 74% at 24 months. In Study 2, responders to A-CT received 8 months (10 sessions) of continuation phase CT (C-CT). In Study 2, relapse or recurrence was 20% at 6 and 8 months, 27% at 12 months, and 36% at 18 and 24 months after A-CT. An exploratory log-rank test showed that relapse or recurrence-free survival was greater in Study 2 than in Study 1. If replicated, this result suggests that C-CT can reduce depressive relapse or recurrence. Alternative explanations are presented.
两项试点研究评估了认知疗法（CT）后复发率（即重度抑郁症）。两个连续队列纳入了对急性期认知疗法（A-CT）有反应且同意每月进行无治疗随访的门诊患者。在研究1中，采用Kaplan-Meier技术估计6个月时复发率为40%，8个月时为45%，12个月时为50%，18个月时为67%，24个月时为74%。在研究2中，对A-CT有反应者接受了8个月（10次疗程）的巩固期认知疗法（C-CT）。在研究2中，A-CT后6个月和8个月时复发率为20%，12个月时为27%，18个月和24个月时为36%。一项探索性对数秩检验显示，研究2中的无复发或无复发生存率高于研究1。如果该结果得到重复验证，则表明C-CT可降低抑郁复发率。文中还提出了其他解释。
