57142
document
Dysfunctional attitudes as a moderator of pharmacotherapy and psychotherapy for chronic depression . OBJECTIVE Individuals with chronic depression exhibit heterogeneous responses to treatment . Important individual differences may therefore exist within this particularly difficult to treat population that act as moderators of treatment response . METHOD The present study examined whether pretreatment levels of dysfunctional attitudes ( DA ) moderated treatment response in a large sample of chronically depressed individuals . Data were taken from the Research Evaluating the Value of Augmenting Medication with Psychotherapy ( REVAMP ) treatment study -- a multi-site treatment and augmentation study of 808 chronically depressed individuals . REVAMP comprised two phases : 1 ) a 12-week open-label antidepressant trial and 2 ) , a subsequent phase , in which phase 1 non-remitters ( N = 491 ) were randomized to either receive an ongoing medication algorithm alone , medication plus cognitive behavioral analysis system of psychotherapy , or medication plus brief supportive psychotherapy . RESULT In phase 1 , compared to the pharmacotherapy response of patients with lower DA scores , the response for patients with higher DA scores was steeper , but leveled off toward the end of the phase . In phase 2 , DA predicted a differential response in the medication only arm , but not in the two psychotherapy + medication conditions . Specifically , in the phase 2 medication only condition , patients with higher DA improved while those with lower DA scores did not . CONCLUSION These results indicate that the relation between DA and treatment response in chronic depression is complex , but suggest that greater DA may be associated with a steeper reduction and/or better response to pharmacotherapy .
57143
Intervention_Pharmacological
pharmacotherapy
57144
Intervention_Psychological
psychotherapy
57145
Intervention_Pharmacological
12-week open-label antidepressant trial
57146
Intervention_Psychological
ongoing medication algorithm alone , medication plus cognitive behavioral analysis system of psychotherapy , or medication plus brief supportive psychotherapy .
57147
Intervention_Psychological
psychotherapy
57148
Intervention_Physical
medication
57149
Intervention_Pharmacological
medication
57150
Intervention_Psychological
pharmacotherapy .
57151
Outcome_Physical
pharmacotherapy response
57152
Outcome_Other
improved
57153
Participant_Condition
chronic depression
57154
Participant_Condition
chronic depression
57155
Participant_Condition
chronically depressed
57156
Participant_Sample-size
808
57157
Participant_Condition
chronically depressed
57158
Participant_Condition
depression