Benefits of MCT Have Been Identified

Fewer data are available for M-CT than for C-CT. Blackburn and Moore (1997) found that 2-year relapse/recurrence rates (HRSD > 15) did not differ significantly among depressed patients randomized to acute-phase followed by maintenance-phase pharmacotherapy (31%), A-CT followed by M-CT (24%), and acute-phase pharmacotherapy followed by M-CT (36%). This study suggested that M-CT is as effective as maintenance-phase pharmacotherapy but lacked a no- or minimal-treatment condition to establish firmly the benefits of M-phase CT. Helping to fill this gap, Klein et al. (2004) randomized patients with chronic depression who responded (reduction in baseline 24-item HRSD score by > 50% to a total score < 15) to cognitive-behavioral analysis system of psychotherapy (CBASP) as an acute-phase treatment (either alone or after failed pharmacotherapy), and who maintained response for 16 weeks with continuation CBASP, to monthly maintenance CBASP or assessment only. After 1 year, maintenance CBASP reduced relapse (meeting MDE criteria by interview checklist or retrospective clinical consensus, plus 24-item HRSD scores > 16 for 2 consecutive weeks) compared to assessment only, 11 versus 32%.

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