Long-term outcomes of once weekly v. twice weekly sessions of cognitive behavioral therapy and interpersonal psychotherapy for depression

Sanne J E Bruijniks*, Steven D Hollon, Lotte H. J. M. Lemmens, Frenk P. M. L. Peeters, Arnoud Arntz, Pim Cuijpers, Jos Twisk, Pieter Dingemanse, Linda Willems, Patricia van Oppen, Michael van den Boogaard, Jan Spijker, Marcus J H Huibers

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background Twice weekly sessions of cognitive behavioral therapy (CBT) and interpersonal psychotherapy (IPT) for major depressive disorder (MDD) lead to less drop-out and quicker and better response compared to once weekly sessions at posttreatment, but it is unclear whether these effects hold over the long run. Aims Compare the effects of twice weekly v. weekly sessions of CBT and IPT for depression up to 24 months since the start of treatment. Methods Using a 2 × 2 factorial design, this multicentre study randomized 200 adults with MDD to once or twice weekly sessions of CBT or IPT over 16-24 weeks, up to a maximum of 20 sessions. Main outcome measures were depression severity, measured with the Beck Depression Inventory-II and the Longitudinal Interval Follow-up Evaluation. Intention-to-treat analyses were conducted. Results Compared with patients who received once weekly sessions, patients who received twice weekly sessions showed a significant decrease in depressive symptoms up through month 9, but this effect was no longer apparent at month 24. Patients who received CBT showed a significantly larger decrease in depressive symptoms up to month 24 compared to patients who received IPT, but the between-group effect size at month 24 was small. No differential effects between session frequencies or treatment modalities were found in response or relapse rates. Conclusions Although a higher session frequency leads to better outcomes in the acute phase of treatment, the difference in depression severity dissipated over time and there was no significant difference in relapse.

Original languageEnglish
Pages (from-to)517-526
Number of pages10
JournalPsychological Medicine
Volume54
Issue number3
Early online date4 Sept 2023
DOIs
Publication statusPublished - 4 Feb 2024

Keywords

  • Cognitive behavioral therapy
  • depression
  • interpersonal psychotherapy
  • long-term effects

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