Cited by 340Psychotherapy Techniques and ApplicationsTreatment of Major DepressionAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Prediction of Response to Medication and Cognitive Therapy in the Treatment of Moderate to Severe Depression.

Open access
Fournier, Jay C., DeRubeis, Robert J., Shelton, Richard C., Hollon, Steven D., Amsterdam, Jay D., Gallop, Robert·2009·Journal of Consulting and Clinical Psychology

Abstract

A recent randomized controlled trial found nearly equivalent response rates for antidepressant medications and cognitive therapy in a sample of moderate to severely depressed outpatients. In this article, the authors seek to identify the variables that were associated with response across both treatments as well as variables that predicted superior response in one treatment over the other. The sample consisted of 180 depressed outpatients: 60 of whom were randomly assigned to cognitive therapy; 120 were assigned to antidepressant medications. Treatment was provided for 16 weeks. Chronic depression, older age, and lower intelligence each predicted relatively poor response across both treatments. Three prescriptive variables-marriage, unemployment, and having experienced a greater number of recent life events-were identified, and each predicted superior response to cognitive therapy relative to antidepressant medications. Thus, 6 markers of treatment outcome were identified, each of which might be expected to carry considerable clinical utility. The 3 prognostic variables identify subgroups that might benefit from alternative treatment strategies; the 3 prescriptive variables identify groups who appear to respond particularly well to cognitive therapy.

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Crossref · 10.1037/a0015401

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68 of 68 references verified0 citation errors · 0 not checkable

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  • Adults with resistant depressive disorders may display traits of overcontrol, such as heightened self-criticism, diminished autonomy, rigid internalized expectations, heightened control over spontaneous emotions, and a fear of making mistakes.

    “Adults with resistant depressive disorders may display traits of overcontrol, such as heightened self-criticism, diminished autonomy, rigid internalized expectations, heightened control over spontaneous emotions, and a fear of making mistakes [28–30].”

    From Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults: A protocol for systematic review and meta-analysis (2024) · cites this paper as [29]

    The Methods > Potential Predictors section (page unavailable) includes perfectionism, need for approval, and self-esteem among variables assessed in depressed outpatients, which overlaps with the claimed traits. It does not establish that adults with treatment-resistant depression display the listed pattern of overcontrol, including reduced autonomy, emotional restraint, or fear of mistakes. The Methods > Participants section (page unavailable) describes a moderate-to-severe depression sample, not a treatment-resistant sample. (LLM, conf=0.78)

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  • These maladaptive responses can prolong depressive symptoms.

    “These maladaptive responses can prolong depressive symptoms [29,30].”

    From Dialectical Behavior Therapy as an intervention for Treatment Resistant Depression in adults: A protocol for systematic review and meta-analysis (2024) · cites this paper as [29]

    The Methods section lists cognitive variables such as attributional style and perfectionism, but does not say that maladaptive responses prolong depression. The Discussion reports that patients with chronic depression had less symptom relief during treatment, without attributing that persistence to maladaptive responses. Searches for maladaptive coping, rumination, and symptom persistence found no passage making the claimed link. (LLM, conf=0.74)

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Cites

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Research works printed but not linked: 5

  1. First M Spitzer R Gibbon M Williams J Structured Clinical Interview for DSMIV-TR- Axis I Disorders, Research Version, Patient Edition With Psychotic Screen (SCID-I/P W/ PSY SCREEN) 2001 New York, NY Biometrics Research, New York State Psychiatric Institute
  2. Hollon SD Beck AT Predicting outcome vs. differential response: matching clients to treatment 1986 Paper presented at the National Institute on Drug Abuse Technical Review Meeting on Matching Clients to Treatment: A Critical Review Rockville, MD
  3. Larsen RJ Diener E Clark MS Promises and problems with the circumplex model of emotion Review of personality and social psychology: Emotion 1992 Vol. 13 Newbury Park, CA Sage 25 59
  4. Rosenberg M Society and the adolescent child 1965 Princeton, NJ Princeton University Press
  5. Spitzer R Williams J Gibbon M First M Structured Clinical Interview for DSMII-R Personality Disorders (SCID-II, Version 1.0) 1990 Washington, DC American Psychiatric Press

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Authors
Fournier, J. C., DeRubeis, R. J., Shelton, R. C., Hollon, S. D., Amsterdam, J. D., & Gallop, R.
Affiliations
  • University of Pennsylvania (US)
  • Vanderbilt University Medical Center (US)
  • Vanderbilt University (US)
  • West Chester University (US)
Venue
Journal of Consulting and Clinical Psychology
Published
2009
Volume
77
Issue
4
Pages
775-787
ISSN
  • 0022-006X (ISSN-L)
  • 1939-2117
OpenAlex
W2085575985
Cited by
340
References
68
Citations by year
2026: 14 · 2025: 7 · 2024: 13 · 2023: 16 · 2022: 21 · 2021: 43 · 2020: 17 · 2019: 29 · 2018: 20 · 2017: 19 · 2016: 23 · 2015: 27 · 2014: 22 · 2013: 20 · 2012: 16
FWCI
16.95
Type
journal article
Language
en
Open access
Locations
  • Journal of Consulting and Clinical Psychology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (MH55877 (R10); MH55875 (R10); MH01697 (K02); MH01741 (K24))
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
depression, antidepressants, cognitive therapy, treatment response prediction, prognostic factors, chronic depression, old age, intelligence, marital status, unemployment, life events, outpatients, treatment selection
MeSH terms
Adult, Antidepressive Agents, Chronic Disease, Combined Modality Therapy, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Personality Inventory, Prognosis, Recurrence, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Age of Onset, Dysthymic Disorder

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