دورية أكاديمية
Differential impact of preventive cognitive therapy while tapering antidepressants versus maintenance antidepressant treatment on affect fluctuations and individual affect networks and impact on relapse: a secondary analysis of a randomised controlled trial.
| العنوان: | Differential impact of preventive cognitive therapy while tapering antidepressants versus maintenance antidepressant treatment on affect fluctuations and individual affect networks and impact on relapse: a secondary analysis of a randomised controlled trial. |
|---|---|
| المؤلفون: | van der Wal JM; Department of Psychiatry, Amsterdam UMC, location AMC, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands.; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands.; Department of Public and Occupational Health, Amsterdam UMC, location VUmc, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands., van Borkulo CD; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands.; Department of Psychological Methods, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, the Netherlands., Haslbeck JMB; Department of Psychological Methods, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, the Netherlands.; Maastricht University, Faculty of Psychology and Neuroscience, Universiteitssingel 40, 6229 ER, Maastricht, the Netherlands., Slofstra C; Lentis Psychiatric Institute, Centre for Integrative Psychiatry Research, Hereweg 80, 9725 AG, Groningen, the Netherlands., Klein NS; Department Trauma Centre, GGZ Drenthe Mental Health Institute, Altingerweg 1, 9411 PA, Beilen, the Netherlands., Blanken TF; Department of Psychological Methods, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, the Netherlands., Deserno MK; Department of Psychological Methods, University of Amsterdam, Nieuwe Achtergracht 129-B, 1018 WS, Amsterdam, the Netherlands., Lok A; Department of Psychiatry, Amsterdam UMC, location AMC, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands.; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands., Nauta MH; Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Bloemstraat 36, 9712 LE, Groningen, the Netherlands., Bockting CL; Department of Psychiatry, Amsterdam UMC, location AMC, Meibergdreef 5, 1105 AZ, Amsterdam, the Netherlands.; Centre for Urban Mental Health, University of Amsterdam, Amsterdam, the Netherlands. |
| المصدر: | EClinicalMedicine [EClinicalMedicine] 2023 Nov 22; Vol. 66, pp. 102329. Date of Electronic Publication: 2023 Nov 22 (Print Publication: 2023). |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: The Lancet Country of Publication: England NLM ID: 101733727 Publication Model: eCollection Cited Medium: Internet ISSN: 2589-5370 (Electronic) Linking ISSN: 25895370 NLM ISO Abbreviation: EClinicalMedicine Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: [London] : The Lancet, [2018]- |
| مستخلص: | Background: There is an urgent need to better understand and prevent relapse in major depressive disorder (MDD). We explored the differential impact of various MDD relapse prevention strategies (pharmacological and/or psychological) on affect fluctuations and individual affect networks in a randomised setting, and their predictive value for relapse. Methods: We did a secondary analysis using experience sampling methodology (ESM) data from individuals with remitted recurrent depression that was collected alongside a randomised controlled trial that ran in the Netherlands, comparing: (I) tapering antidepressants while receiving preventive cognitive therapy (PCT), (II) combining antidepressants with PCT, or (III) continuing antidepressants without PCT, for the prevention of depressive relapse, as well as ESM data from 11 healthy controls. Participants had multiple past depressive episodes, but were remitted for at least 8 weeks and on antidepressants for at least six months. Exclusion criteria were: current (hypo)mania, current alcohol or drug abuse, anxiety disorder that required treatment, psychological treatment more than twice per month, a diagnosis of organic brain damage, or a history of bipolar disorder or psychosis. Fluctuations (within-person variance, root mean square of successive differences, autocorrelation) in negative and positive affect were calculated. Changes in individual affect networks during treatment were modelled using time-varying vector autoregression, both with and without applying regularisation. We explored whether affect fluctuations or changes in affect networks over time differed between treatment conditions or relapse outcomes, and predicted relapse during 2-year follow-up. This ESM study was registered at ISRCTN registry, ISRCTN15472145. Findings: Between Jan 1, 2014, and Jan 31, 2015, 72 study participants were recruited, 42 of whom were included in the analyses. We found no indication that affect fluctuations differed between treatment groups, nor that they predicted relapse. We observed large individual differences in affect network structure across participants (irrespective of treatment or relapse status) and in healthy controls. We found no indication of group-level differences in how much networks changed over time, nor that changes in networks over time predicted time to relapse (regularised models: hazard ratios [HR] 1063, 95% CI <0.0001->10 000, p = 0.65; non-regularised models: HR 2.54, 95% CI 0.23-28.7, p = 0.45) or occurrence of relapse (regularised models: odds ratios [OR] 22.84, 95% CI <0.0001->10 000, p = 0.90; non-regularised models: OR 7.57, 95% CI 0.07-3709.54, p = 0.44) during complete follow-up. Interpretation: Our findings should be interpreted with caution, given the exploratory nature of this study and wide confidence intervals. While group-level differences in affect dynamics cannot be ruled out due to low statistical power, visual inspection of individual affect networks also revealed no meaningful patterns in relation to MDD relapse. More studies are needed to assess whether affect dynamics as informed by ESM may predict relapse or guide personalisation of MDD relapse prevention in daily practice. Funding: The Netherlands Organisation for Health Research and Development, Dutch Research Council, University of Amsterdam. Competing Interests: CLB is co-editor of Clinical Psychology Europe and Proceedings of the European Academy of Sciences and Arts. CLB is co-developer of the Dutch multidisciplinary clinical guideline for anxiety and depression (non-remunerated) and member of the scientific advisory board of the National Insure Institute, for which she receives an honorarium (no direct relation to this study). CLB has presented keynote addresses at conferences, such as the European Psychiatry Association and the European Conference Association, for which she sometimes receives an honorarium. She has presented clinical training workshops, some of which include a fee. CLB receives royalties from her books and co-edited books, and she developed PCT on the basis of the cognitive model of AT Beck. MHN reports travel expenses, some subsistence, and speaker honoraria for lectures and clinical training workshops, and is a member of the workgroup of the Dutch multi-disciplinary guideline for anxiety (non-remunerated). All other authors declare no competing interests. (© 2023 The Author(s).) |
| References: | Contemp Clin Trials Commun. 2017 Jul 12;7:172-178. (PMID: 29696182) Arch Gen Psychiatry. 2006 Jul;63(7):749-55. (PMID: 16818864) J Pers Soc Psychol. 1988 Jun;54(6):1063-70. (PMID: 3397865) Front Psychiatry. 2020 Oct 22;11:574357. (PMID: 33192705) PLoS One. 2015 Jun 18;10(6):e0129722. (PMID: 26087323) Psychol Bull. 1985 Sep;98(2):219-35. (PMID: 3901060) Proc Natl Acad Sci U S A. 2014 Jan 7;111(1):87-92. (PMID: 24324144) Multivariate Behav Res. 2021 Jan-Feb;56(1):120-149. (PMID: 32324066) Clin Psychol Rev. 2019 Dec;74:101773. (PMID: 31756681) J Consult Clin Psychol. 2013 Jun;81(3):508-17. (PMID: 23477478) Clin Psychol Psychother. 2012 Jul-Aug;19(4):283-90. (PMID: 22653834) Psychiatr Serv. 2019 Nov 1;70(11):983-991. (PMID: 31434558) JAMA. 2021 Aug 3;326(5):433-434. (PMID: 34342631) Behav Res Ther. 2022 Feb;149:104011. (PMID: 34998034) Lancet Psychiatry. 2018 May;5(5):401-410. (PMID: 29625762) Psychol Med. 2023 May;53(7):3124-3132. (PMID: 34937601) Psychother Psychosom. 2016;85(2):114-6. (PMID: 26821231) J Pers Oriented Res. 2020 Sep 10;6(1):1-15. (PMID: 33569148) Psychol Methods. 2023 Oct;28(5):1052-1068. (PMID: 34990189) Clin Psychol Rev. 2015 Nov;41:16-26. (PMID: 25754289) Psychol Med. 2021 Aug;51(11):1906-1915. (PMID: 32234092) Psychother Psychosom. 2018;87(4):243-245. (PMID: 29758551) Int J Bipolar Disord. 2020 Dec 1;8(1):38. (PMID: 33258015) Behav Res Ther. 2010 Nov;48(11):1105-12. (PMID: 20810101) BMC Psychiatry. 2011 Jan 12;11:8. (PMID: 21226937) Br J Psychol. 2019 Nov;110(4):814-827. (PMID: 30588616) Emotion. 2023 Dec;23(8):2117-2141. (PMID: 37166827) JAMA Psychiatry. 2021 Aug 1;78(8):868-875. (PMID: 34009273) Mol Psychiatry. 2021 Jan;26(1):118-133. (PMID: 32704061) Psychother Psychosom. 2020;89(5):283-306. (PMID: 32259826) Emotion. 2013 Dec;13(6):1132-41. (PMID: 23914765) Clin Psychol Rev. 2015 Nov;41:27-39. (PMID: 26197726) |
| فهرسة مساهمة: | Keywords: Affect fluctuations; Ecological momentary assessment; Network theory; Personalisation; Recurrent depression; Relapse prevention |
| تواريخ الأحداث: | Date Created: 20231211 Latest Revision: 20231211 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10700372 |
| DOI: | 10.1016/j.eclinm.2023.102329 |
| PMID: | 38078193 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 2589-5370 |
|---|---|
| DOI: | 10.1016/j.eclinm.2023.102329 |