Skip to main content Accessibility help
×
Home

Long-term outcomes of trials in the National Institute for Health and Care Excellence depression guideline

  • Susan McPherson (a1) and Michael P. Hengartner (a2)

Summary

The forthcoming National Institute for Health and Care Excellence depression guideline reviews short-term outcomes for long-term depression. We present effect sizes for long-term outcomes in trials that report these data. Psychological therapies become more effective, whereas antidepressants become less effective over the long term. We review other forms of longitudinal research that support these findings.

Declaration of interest

None.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Long-term outcomes of trials in the National Institute for Health and Care Excellence depression guideline
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Long-term outcomes of trials in the National Institute for Health and Care Excellence depression guideline
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Long-term outcomes of trials in the National Institute for Health and Care Excellence depression guideline
      Available formats
      ×

Copyright

This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.

Corresponding author

Correspondence: Susan McPherson, School of Health and Social Care, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK. Email: smcpher@essex.ac.uk

References

Hide All
1National Institute for Health and Care Excellence (NICE). Depression in adults: treatment and management. Addendum Consultation. NICE, 2018 (www.nice.org.uk/guidance/gid-cgwave0725/documents).
2National Institute for Health and Care Excellence (NICE). Depression in adults: treatment and management. Consultation comments and responses – second consultation period. NICE, 2018 (https://www.nice.org.uk/guidance/gid-cgwave0725/documents/consultation-comments-and-responses-2).
3Wise, J. NICE guidance on depression: 35 organisations demand ‘full and proper revision’. BMJ 2019; 365: I2356.
4McPherson, S. A NICE game of Minecraft: philosophical flaws underpinning UK depression guideline methodology. Med Humanit 2019, in press.
5Gueorguieva, R, Chekroud, A, Krystal, J. Trajectories of relapse in randomised, placebo-controlled trials of treatment discontinuation in major depressive disorder : an individual patient-level data meta-analysis. Lancet Psychiatry 2017; 4: 230–7.
6Andrews, P, Kornstein, S, Halberstadt, C, Gardener, C, Neale, M. Blue again: perturbational effects of antidepressants suggest monoaminergic homeostasis in major depression. Front Psychol 2011; 2: 159.
7El-Mallakh, R, Briscoe, B. Studies of long-term use of antidepressants: how should the data from them be interpreted? CNS Drugs 2012; 26: 97109.
8Fava, GA, Offidani, E. The mechanisms of tolerance in antidepressant action. Prog Neuro Psychopharmacol Biol Psychiatry 2011; 35: 1593–602.
9Cohen, D, Recalt, AM. Discontinuing psychotropic drugs from participants in randomized controlled trials: a systematic review. Psychother Psychosom 2019; 88: 96104.
10Hengartner, MP, Angst, J, Rossler, W. Antidepressant use prospectively relates to a poorer long-term outcome of depression: results from a prospective community cohort study over 30 years. Psychother Psychosom 2018; 87: 181–3.
11Bockting, CLH, ten Doesschate, MC, Spijker, J, Koeter, MWJ, Schene, AH. Continuation and maintenance use of antidepressants in recurrent depression. Psychother Psychosoms 2008; 77: 1726.
12Groot, PC, van Os, J. Antidepressant tapering strips to help people come off medication more safely. Psychosis 2018; 10: 142–5.
13Fava, GA, Gatti, A, Belaise, C, Guidi, J, Offidani, E. Withdrawal symptoms after selective serotonin reuptake inhibitor discontinuation: a systematic review. Psychother Psychosom 2015; 84: 7281.
14Read, J, Cartwright, C, Gibson, K. Adverse emotional and interpersonal effects reported by 1829 New Zealanders while taking antidepressants. Psychiatry Res 2014; 216: 6773.
15Biesheuvel-Leliefeld, KE, Kok, GD, Bockting, CL, Cuijpers, P, Hollon, SD, van Marwijk, HW, et al. Effectiveness of psychological interventions in preventing recurrence of depressive disorder: meta-analysis and meta-regression. J Affect Disord 2015; 174: 400–10.
16Karyotaki, E, Smit, Y, Holdt Henningsen, K, Huibers, MJ, Robays, J, de Beurs, D, et al. Combining pharmacotherapy and psychotherapy or monotherapy for major depression? A meta-analysis on the long-term effects. J Affect Disord 2016; 194: 144–52.
17Guidi, J, Tomba, E, Fava, GA. The sequential integration of pharmacotherapy and psychotherapy in the treatment of major depressive disorder: a meta-analysis of the sequential model and a critical review of the literature. Am J Psychiatry 2016; 173(2): 128–37.
18Kuyken, W, Warren, FC, Taylor, RS, Whalley, B, Crane, C, Bondolfi, G, et al. Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: an individual patient data meta-analysis from randomized trials. JAMA Psychiatry 2016; 73(6): 565–74.
19Driessen, E, Van, HL, Don, FJ, Peen, J, Kool, S, Westra, D, et al. The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: a randomized clinical trial. Am J Psychiatry 2013; 170: 1041–50.
20Leuzinger-Bohleber, M, Hautzinger, M, Fiedler, G, Keller, W, Bahrke, U, Kallenbach, L, et al. Outcome of psychoanalytic and cognitive-behavioural long-term therapy with chronically depressed patients: a controlled trial with preferential and randomized allocation. Can J Psychiatry 2019; 64: 4758.
21Steinert, C, Hofmann, M, Kruse, J, Leichsenring, F. Relapse rates after psychotherapy for depression - stable long-term effects? A meta-analysis. J Affect Disord 2014; 168: 107–18.
22Pigott, HE, Leventhal, AM, Alter, GS, Boren, JJ. Efficacy and effectiveness of antidepressants: current status of research. Psychother Psychosom 2010; 79: 267–79.
23Hughes, S, Cohen, D. A systematic review of long term studies of drug treated and non-drug treated depression. J Affect Disord 2009; 118: 918.
24Paykel, ES, Scott, J, Teasdale, JD, Johnson, AL, Garland, A, Moore, R, et al. Prevention of relapse in residual depression by cognitive therapy: a controlled trial. Arch Gen Psych 1999; 56(9): 829–35.
25Valenstein, M, Pfeiffer, PN, Brandfon, S, Walters, H, Ganoczy, D, Kim, HM, et al. Augmenting ongoing depression care with a mutual peer support intervention versus self-help materials alone: a randomized trial. Psych Serv 2015; 67(2): 236–9.
26Hellerstein, DJ, Little, SA, Samstag, LW, Batchelder, S. Adding group psychotherapy to medication treatment in dysthymia. J Psychother Pract Res 2001; 10(2): 93.
27Browne, G, Steiner, M, Roberts, J, Gafni, A, Byrne, C, Dunn, E, et al. Sertraline and/or interpersonal psychotherapy for patients with dysthymic disorder in primary care: 6-month comparison with longitudinal 2-year follow-up of effectiveness and costs. J Aff Dis 2002; 68(2): 317–30.
28Schramm, E, Zobel, I, Schoepf, D, Fangmeier, T, Schnell, K, Walter, H, et al. Cognitive behavioral analysis system of psychotherapy versus escitalopram in chronic major depression. Psychother Psychosom 2015; 84(4): 227–40.
29Schramm, E, Zobel, I, Dykierek, P, Kech, S, Brakemeier, EL, Külz, A, et al. Cognitive behavioral analysis system of psychotherapy versus interpersonal psychotherapy for early-onset chronic depression: a randomized pilot study. J Aff Dis 2011; 129(1): 109–16.
30Wiles, N, Thomas, L, Abel, A, Ridgway, N, Turner, N, Campbell, J, et al. Cognitive behavioural therapy as an adjunct to pharmacotherapy for primary care based patients with treatment resistant depression: results of the CoBalT randomised controlled trial. Lancet 2013; 381(9864): 375–84.
31Fonagy, P, Rost, F, Carlyle, JA, McPherson, S, Thomas, R, Pasco Fearon, RM, et al. Pragmatic randomized controlled trial of long-term psychoanalytic psychotherapy for treatment-resistant depression: the Tavistock Adult Depression Study (TADS). World Psychiatry 2015; 14(3): 312–21.
32Chiesa, A, Castagner, V, Andrisano, C, Serretti, A, Mandelli, L, Porcelli, S, et al. Mindfulness-based cognitive therapy vs. psycho-education for patients with major depression who did not achieve remission following antidepressant treatment. Psychiatry Res 2015; 226(2): 474–83.
33de Mello, MF, Myczcowisk, LM, Menenzes, PR. A randomized controlled trial comparing moclobemide and moclobemide plus interpersonal psychotherapy in the treatment of dysthymic disorder. J Psychother Pract Res 2001; 10(2): 117.
34Schramm, E, Schneider, D, Zobel, I, van Calker, D, Dykierek, P, Kech, S, et al. Efficacy of interpersonal psychotherapy plus pharmacotherapy in chronically depressed inpatients. J Aff Dis 2008; 109(1): 6573.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

Long-term outcomes of trials in the National Institute for Health and Care Excellence depression guideline

  • Susan McPherson (a1) and Michael P. Hengartner (a2)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *