Predicting response to cognitive therapy and interpersonal therapy, with or without antidepressant medication, for major depression: A pragmatic trial in routine practice

M.J.H. Huibers, G. van Breukelen, J. Roelofs, S.D. Hollon, J.C. Markowitz, J. van Os, A. Arntz, F. Peeters

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

BACKGROUND: Identifying patient characteristics that predict response within treatments (prognostic) or between treatments (prescriptive) can inform clinical decision-making. In this study, we sought to identify predictors of response to evidence-based treatments in a sample of depressed patients seeking help in routine practice. METHODS: Data come from a pragmatic trial of 174 patients with major depression who received an evidence-based treatment of their own choice: cognitive therapy (CT), interpersonal therapy (IPT), antidepressant medication (ADM) alone or in combination with either of the two psychotherapies. Patient characteristics measured at baseline were examined to see if they predicted subsequent response as measured with the Beck Depression Inventory (BDI) over the course of 26 weeks of treatment, using mixed regression modeling. RESULTS: Higher agoraphobia scores at baseline predicted more change in depression scores across treatments, irrespective of the treatment received. Physical functioning moderated the response to treatment: patients with high physical functioning fared better in combined treatment than patients with low physical functioning, whereas physical functioning did not predict a differential response in the psychotherapy group. Moreover, the lowest levels of physical functioning predicted an increase of depressive symptoms in combined treatment. LIMITATIONS: A relatively small sample size, and selection of several predictors that were less theory-driven, which hampers the translation to clinical practice. CONCLUSIONS: If replicated, the prognostic and prescriptive indices identified in this study could guide decision-making in routine practice. Development of more uniform requirements for the analysis and reporting of prediction studies is recommended.
Original languageEnglish
Pages (from-to)146-154
Number of pages9
JournalJournal of Affective Disorders
Volume152-154
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • Depression
  • Evidence-based treatments
  • Psychotherapy
  • Antidepressant medication
  • Prediction of response
  • MENTAL-HEALTH TREATMENT
  • BEHAVIORAL THERAPY
  • NATIONAL-INSTITUTE
  • PSYCHOTHERAPY
  • PHARMACOTHERAPY
  • RUMINATION
  • DISORDERS
  • MEDIATORS
  • MODERATE
  • VALIDATION

Cite this

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title = "Predicting response to cognitive therapy and interpersonal therapy, with or without antidepressant medication, for major depression: A pragmatic trial in routine practice",
abstract = "BACKGROUND: Identifying patient characteristics that predict response within treatments (prognostic) or between treatments (prescriptive) can inform clinical decision-making. In this study, we sought to identify predictors of response to evidence-based treatments in a sample of depressed patients seeking help in routine practice. METHODS: Data come from a pragmatic trial of 174 patients with major depression who received an evidence-based treatment of their own choice: cognitive therapy (CT), interpersonal therapy (IPT), antidepressant medication (ADM) alone or in combination with either of the two psychotherapies. Patient characteristics measured at baseline were examined to see if they predicted subsequent response as measured with the Beck Depression Inventory (BDI) over the course of 26 weeks of treatment, using mixed regression modeling. RESULTS: Higher agoraphobia scores at baseline predicted more change in depression scores across treatments, irrespective of the treatment received. Physical functioning moderated the response to treatment: patients with high physical functioning fared better in combined treatment than patients with low physical functioning, whereas physical functioning did not predict a differential response in the psychotherapy group. Moreover, the lowest levels of physical functioning predicted an increase of depressive symptoms in combined treatment. LIMITATIONS: A relatively small sample size, and selection of several predictors that were less theory-driven, which hampers the translation to clinical practice. CONCLUSIONS: If replicated, the prognostic and prescriptive indices identified in this study could guide decision-making in routine practice. Development of more uniform requirements for the analysis and reporting of prediction studies is recommended.",
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author = "M.J.H. Huibers and {van Breukelen}, G. and J. Roelofs and S.D. Hollon and J.C. Markowitz and {van Os}, J. and A. Arntz and F. Peeters",
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doi = "10.1016/j.jad.2013.08.027",
language = "English",
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Predicting response to cognitive therapy and interpersonal therapy, with or without antidepressant medication, for major depression: A pragmatic trial in routine practice. / Huibers, M.J.H.; van Breukelen, G.; Roelofs, J.; Hollon, S.D.; Markowitz, J.C.; van Os, J.; Arntz, A.; Peeters, F.

In: Journal of Affective Disorders, Vol. 152-154, 01.01.2014, p. 146-154.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Predicting response to cognitive therapy and interpersonal therapy, with or without antidepressant medication, for major depression: A pragmatic trial in routine practice

AU - Huibers, M.J.H.

AU - van Breukelen, G.

AU - Roelofs, J.

AU - Hollon, S.D.

AU - Markowitz, J.C.

AU - van Os, J.

AU - Arntz, A.

AU - Peeters, F.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - BACKGROUND: Identifying patient characteristics that predict response within treatments (prognostic) or between treatments (prescriptive) can inform clinical decision-making. In this study, we sought to identify predictors of response to evidence-based treatments in a sample of depressed patients seeking help in routine practice. METHODS: Data come from a pragmatic trial of 174 patients with major depression who received an evidence-based treatment of their own choice: cognitive therapy (CT), interpersonal therapy (IPT), antidepressant medication (ADM) alone or in combination with either of the two psychotherapies. Patient characteristics measured at baseline were examined to see if they predicted subsequent response as measured with the Beck Depression Inventory (BDI) over the course of 26 weeks of treatment, using mixed regression modeling. RESULTS: Higher agoraphobia scores at baseline predicted more change in depression scores across treatments, irrespective of the treatment received. Physical functioning moderated the response to treatment: patients with high physical functioning fared better in combined treatment than patients with low physical functioning, whereas physical functioning did not predict a differential response in the psychotherapy group. Moreover, the lowest levels of physical functioning predicted an increase of depressive symptoms in combined treatment. LIMITATIONS: A relatively small sample size, and selection of several predictors that were less theory-driven, which hampers the translation to clinical practice. CONCLUSIONS: If replicated, the prognostic and prescriptive indices identified in this study could guide decision-making in routine practice. Development of more uniform requirements for the analysis and reporting of prediction studies is recommended.

AB - BACKGROUND: Identifying patient characteristics that predict response within treatments (prognostic) or between treatments (prescriptive) can inform clinical decision-making. In this study, we sought to identify predictors of response to evidence-based treatments in a sample of depressed patients seeking help in routine practice. METHODS: Data come from a pragmatic trial of 174 patients with major depression who received an evidence-based treatment of their own choice: cognitive therapy (CT), interpersonal therapy (IPT), antidepressant medication (ADM) alone or in combination with either of the two psychotherapies. Patient characteristics measured at baseline were examined to see if they predicted subsequent response as measured with the Beck Depression Inventory (BDI) over the course of 26 weeks of treatment, using mixed regression modeling. RESULTS: Higher agoraphobia scores at baseline predicted more change in depression scores across treatments, irrespective of the treatment received. Physical functioning moderated the response to treatment: patients with high physical functioning fared better in combined treatment than patients with low physical functioning, whereas physical functioning did not predict a differential response in the psychotherapy group. Moreover, the lowest levels of physical functioning predicted an increase of depressive symptoms in combined treatment. LIMITATIONS: A relatively small sample size, and selection of several predictors that were less theory-driven, which hampers the translation to clinical practice. CONCLUSIONS: If replicated, the prognostic and prescriptive indices identified in this study could guide decision-making in routine practice. Development of more uniform requirements for the analysis and reporting of prediction studies is recommended.

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KW - Evidence-based treatments

KW - Psychotherapy

KW - Antidepressant medication

KW - Prediction of response

KW - MENTAL-HEALTH TREATMENT

KW - BEHAVIORAL THERAPY

KW - NATIONAL-INSTITUTE

KW - PSYCHOTHERAPY

KW - PHARMACOTHERAPY

KW - RUMINATION

KW - DISORDERS

KW - MEDIATORS

KW - MODERATE

KW - VALIDATION

U2 - 10.1016/j.jad.2013.08.027

DO - 10.1016/j.jad.2013.08.027

M3 - Article

VL - 152-154

SP - 146

EP - 154

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -