Early improvement during manual-guided cognitive and dynamic psychotherapies predicts 16-week remission status

Abstract

This study examined the extent to which improvement from baseline to weeks 2, 3, and 4 on the Beck Depression Inventory and Beck Anxiety Inventory predict week 16 clinical remission for patients with major depressive disorder, generalized anxiety disorder, and/or obsessive-compulsive or avoidant personality disorders who were receiving manual-based psychotherapies. Logistic regression and receiver-operator characteristic analyses revealed relatively accurate identification of remitters and nonremitters based on improvement from baseline to sessions 2 to 4 in both original and cross-validation samples. Predictive success did not vary as a function of diagnosis, treatment type (cognitive or dynamic), or treatment status (short-term or long-term). The clinical implications of the results are discussed.

FIGURE 1.

Receiver-operator characteristic curve for early improvement in Beck Depression Inventory score (from baseline to session 2) predicting remission of symptoms at week 16The data produce a curve that is above and to the left of the diagonal line, indicating that the “predictive test” yields better prediction than chance.