Patterns of early change and their relationship to outcome and follow-up among patients with major depressive disorders
Abstract
Background While highlighting the efficacy of different treatments for major depressive disorders (MDD), findings of the National Institute of Mental Health (NIMH) Treatment of Depression Collaborative Research Program (TDCRP) often are interpreted as supporting the idea of treatment non-specificity for MDD. However, heterogeneity in treatment courses and outcomes might be undetected when focusing only on types of treatment in terms of sample means without taking into account early change in treatment.Method In this study, growth mixture models (GMM) were used in the completer sample of N=162 patients from the NIMH TDCRP to identify meaningful patterns of early change of depression severity that are shared by many individual patients.Results Results revealed three typical patterns of early change over the first 8 weeks of treatment irrespective of the type of treatment protocol provided: (a) moderate to severe depression with moderate early improvement, (b) moderate to severe depression with rapid early improvement, and (c) mild to moderate depression with moderate early improvement. In contrast to the type of treatment, these differential patterns of early response (together with overall pre-treatment symptom severity) predicted outcomes (i.e. depression severity) at treatment termination and over the 1.5-year follow-up period.Limitations Due to the small sample size and the controlled setting of this study the degree to which these results can be generalized to clinical practice has to be further investigated.Conclusions The findings provide further support for the assumption that early change is an important factor for the prediction of short- and long-term outcome in psychotherapy.
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Rapid response to CBT is associated with long-term improvements in functioning and a reduction in long-term relapse rates.
“Furthermore, this rapid response is associated with long-term improvements in functioning and a reduction in long-term relapse rates [39,43,45].”
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- Authors
- Lutz, W., Stulz, N., & Köck, K.
- Affiliations
- Universität Trier (DE)
- University of Pennsylvania (US)
- Corresponding author
- Lutz, Wolfgang
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2009-11
- Volume
- 118
- Issue
- 1-3
- Pages
- 60-68
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W2026334685
- Cited by
- 186
- References
- 70
- Citations by year
- 2026: 9 · 2025: 5 · 2024: 7 · 2023: 9 · 2022: 12 · 2021: 35 · 2020: 8 · 2019: 11 · 2018: 12 · 2017: 11 · 2016: 7 · 2015: 18 · 2014: 6 · 2013: 10 · 2012: 10
- FWCI
- 8.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- major depressive disorder, early treatment response, treatment outcome prediction, follow-up outcomes, depression severity, growth mixture modeling, psychotherapy
- MeSH terms
- Adult, Ambulatory Care, Antidepressive Agents, Antidepressive Agents, Tricyclic, Combined Modality Therapy, Major Depressive Disorder, Female, Follow-Up Studies, Humans, Imipramine, Male, Middle Aged, Patient Admission, Personality Inventory, Psychometrics, Psychotherapy, Cognitive Behavioral Therapy, Treatment Outcome
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