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Question In patients who have recurrent depression after successful antidepressant treatment, is cognitive behavioural therapy (CBT) effective for reducing residual symptoms and relapse rates?
Randomised controlled trial with 24 months of follow up.
An affective disorders programme in Bologna, Italy.
45 patients were enrolled, and 40 (89%) were analysed (mean age 47 y, 60% women). Patients had major depressive disorder according to the Research Diagnostic Criteria for a Selected Group of Functional Disorders with a global severity score of ≥7; ≥3 episodes of depression; ≤2.5 years between the previous depressive episode and onset of the current episode; ≤10 weeks of remission between the index episode and the previous depressive episode; and a successful response to antidepressants. Exclusion criteria were any medical illness; and history of manic, hypomanic, or cyclothymic features; antecedent dysthymia; substance abuse; or personality disorder.
Patients were allocated to CBT (n=20) or clinical management (CM) (n=20). Antidepressant drugs were tapered (at the rate of 25 mg of amitriptyline hydrochloride [or its equivalent] every other week) and stopped. CBT and CM were given in 10 sessions of 30 …
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