Quality of life after response to acute-phase cognitive therapy for recurrent depression
Open accessAbstract
Background Adults with major depressive disorder (MDD) often experience reduced quality of life (QOL). Efficacious acute-phase treatments, including cognitive therapy (CT) or medication, decrease depressive symptoms and, to a lesser degree, increase QOL. We tested longer-term changes in QOL after response to acute-phase CT, including the potential effects of continuation treatment for depression and time-lagged relations between QOL and depressive symptoms.Methods Responders to acute-phase CT (N = 290) completed QOL and depressive symptom assessments repeatedly for 32 post-acute months. Higher-risk responders were randomized to 8 months of continuation treatment (CT, fluoxetine, or pill placebo) and then entered a 24-month follow-up. Lower-risk responders were only assessed for 32 months.Results On average, large gains in QOL made during acute-phase CT response were maintained for 32 months. Continuation CT or fluoxetine did not improve QOL relative to pill placebo. Controlling for residual depressive symptoms, higher QOL after acute-phase CT response was a protective factor against MDD relapse and recurrence. Higher QOL predicted subsequent reductions in depressive symptom severity, but depressive symptom severity did not predict subsequent changes in QOL.Limitations Generalization of results to other patient populations, treatments, and measures is uncertain. The clinical trial was not designed to test relations between QOL and depression. Replication is needed before clinical application of these results.Conclusions Gains in QOL made during response to acute-phase CT are relatively stable and may help protect against relapse/recurrence. Continuation CT or fluoxetine may not further improve QOL among acute-phase CT responders.
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QOL improvement has been evidenced to predict lower odds of depression relapse and recurrence.
“Further, QOL improvement has been evidenced to predict lower odds of depression relapse and recurrence and thus, is a very important outcome for interventions [83].”
From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [83]
The Results section reports that higher quality of life after response to acute-phase cognitive therapy predicted less relapse or recurrence. But the analysis used quality-of-life level at that point, not improvement in quality of life, as the predictor; it therefore does not establish the claim about improvement specifically. (LLM, conf=0.87)
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- Authors
- Vittengl, J. R., Jha, M. K., Minhajuddin, A., Thase, M. E., & Jarrett, R. B.
- Affiliations
- Truman State University (US)
- Icahn School of Medicine at Mount Sinai (US)
- The University of Texas Southwestern Medical Center (US)
- University of Pennsylvania (US)
- Corresponding author
- Vittengl, Jeffrey R.
- Jarrett, Robin B.
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2021-01
- Volume
- 278
- Pages
- 218-225
- ISSN
- 0165-0327 (ISSN-L)
- PMC
- PMC7704560
- OpenAlex
- W3087570700
- Cited by
- 12
- References
- 47
- Citations by year
- 2026: 3 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 2
- FWCI
- 1.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- quality of life, major depressive disorder, recurrent depression, cognitive therapy, continuation treatment, fluoxetine, relapse prevention, depression recurrence, residual depressive symptoms, long-term outcomes
- MeSH terms
- Adult, Depression, Depressive Disorder, Major, Major Depressive Disorder, Fluoxetine, Follow-Up Studies, Humans, Quality of Life, Recurrence, Cognitive Behavioral Therapy, Treatment Outcome
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