Does early intervention increase latency to relapse in major depressive disorder?: re-evaluation with cognitive behavior therapy

Abstract 

Background: Major depressive disorder (MDD) has been studied in relation to its propensity for remission and likelihood of relapse. While the general clinical lore suggests that early intervention benefits treatment outcome, the empirical validation of this assumption is inconclusive. Specifically, no studies have been conducted concerning Time to Treatment Entry and long-term clinical course for MDD. Methods: For the current study, 53 participants received 16-weeks of cognitive behavioral therapy (CBT). Participants who remitted (n=41) from their depression were then inducted into a longitudinal follow-up protocol. Results: Longer Time to Treatment Entry was predictive of longer time to relapse. A greater number of previous depressive episodes was associated with decreased Time to Treatment Entry. Limitations: A more elaborate protocol could be designed in order to explore the nature of treatment effects and Time to Treatment Entry within one study. Conclusions: CBT may be the most effective for patients who have delayed seeking treatment. Although the present study adds to the developmental neurobiological assumptions of Post [Severe depressive disorders (1994) 23–65] concerning affective ‘kindling,’ it also challenges the kindling theory’s assumptions concerning early intervention.

Keywords:  Early intervention, Time to treatment entry, Relapse risk, Depression, Major depressive disorder