Randomized Trial of Behavioral Activation, Cognitive Therapy, and Antidepressant Medication in the Prevention of Relapse and Recurrence in Major Depression

Keith S. Dobson*, Steven D. Hollon, Sona Dimidjian, Karen B. Schmaling, Robert J. Kohlenberg, Robert J. Gallop, Shireen L. Rizvi, Jackie K. Gollan, David L. Dunner, Neil S. Jacobson

*Corresponding author for this work

Research output: Contribution to journalArticle

298 Scopus citations

Abstract

This study followed treatment responders from a randomized controlled trial of adults with major depression. Patients treated with medication but withdrawn onto pill-placebo had more relapse through 1 year of follow-up compared to patients who received prior behavioral activation, prior cognitive therapy, or continued medication. Prior psychotherapy was also superior to medication withdrawal in the prevention of recurrence across the 2nd year of follow-up. Specific comparisons indicated that patients previously exposed to cognitive therapy were significantly less likely to relapse following treatment termination than patients withdrawn from medication, and patients previously exposed to behavioral activation did almost as well relative to patients withdrawn from medication, although the difference was not significantly different. Differences between behavioral activation and cognitive therapy were small in magnitude and not significantly different across the full 2-year follow-up, and each therapy was at least as efficacious as the continuation of medication. These findings suggest that behavioral activation may be nearly as enduring as cognitive therapy and that both psychotherapies are less expensive and longer lasting alternatives to medication in the treatment of depression.

Original languageEnglish (US)
Pages (from-to)468-477
Number of pages10
JournalJournal of Consulting and Clinical Psychology
Volume76
Issue number3
DOIs
StatePublished - Jun 2008

Keywords

  • antidepressant medication
  • behavioral activation
  • cognitive therapy
  • major depression
  • relapse

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health

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