Perspectives on the course of major depression: Trajectories of remission and relapse with CBT or no treatment

Abstract

To provide a normative backdrop by which clinical-researchers and clinicians can consider the benefits of cognitive behavioral therapy (CBT) for major depressive disorder (MDD), we consider what is known and what can be extrapolated about the average patterns of remission and relapse for CBT-treated versus untreated individuals with MDD. To achieve this, a detailed analysis of the average monthly trajectories experienced by CBT-treated patients is performed: remission during the duration of acute-phase (three months) and continuation-phase CBT (nine months thereafter) as well as relapse during the year following remission are examined utilizing published clinical trial data. We contextualize these mean treatment trajectories with comparative trajectories of untreated individuals and provide both graphical (primary outcome) and textual information on the patterns of remission and relapse as judged by the current literature. Finally, through investigating these trajectories, we also present where the current literature is and is not well-informed on the longitudinal course of CBT-treated and untreated MDD.