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Am J Psychiatry 1994; 151:1295-1299
Copyright © 1994 by American Psychiatric Association
Cognitive behavioral treatment of residual symptoms in primary major depressive disorder
GA Fava, S Grandi, M Zielezny, R Canestrari and MA Morphy
Department of Psychology, University of Bologna, Italy.
OBJECTIVE: Cognitive behavioral treatment has been used extensively in the
acute phase of depression. The purpose of this study was to determine the
applicability and effectiveness of this treatment modality in addressing
the residual symptoms of primary major depressive illness. METHOD: The
subjects were 40 patients with major depressive disorder who were
successfully treated with antidepressant drugs. They were then randomly
assigned to either cognitive behavioral treatment or clinical management of
residual symptoms. In both subgroups, antidepressant drugs were tapered and
discontinued. RESULTS: The group that received cognitive behavioral
treatment had a significantly lower level of residual symptoms after drug
discontinuation in comparison with the clinical management group. Cognitive
behavioral treatment also resulted in a lower rate of relapse (15%) at a
2-year follow-up than did clinical management (35%), although this
difference did not reach statistical significance. Most of the residual
symptoms were found to have occurred also in the prodromal phase of
illness. CONCLUSIONS: This preliminary study points to the potential
clinical advantages of cognitive behavioral treatment targeted to the
residual symptoms of depression.
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