Residual symptoms in depressed patients who successfully respond to short-term psychotherapy

Background: Most investigations of residual symptoms have focused on partial responders to antidepressant medications. Comparatively few have examined residual symptoms among patients who achieved a more successful response to treatment. In addition, few studies have assessed residual symptoms among patients treated with psychotherapy. The purpose of the present study was to assess residual symptoms of depression among psychiatric outpatients who successfully responded to psychotherapy and determine their association with other important clinical outcomes. Methods: Sixty patients with major depression who participated in a randomized controlled trial of two forms of short-term, individual psychotherapy were studied. We examined the prevalence of residual symptoms among successful responders, as well as the relationships between residual symptoms, pre-therapy patient characteristics, relapse, and other outcomes. Results: Thirty-three (55%) of the 60 patients responded successfully to psychotherapy. Of those, 82% had residual symptoms. Residual symptoms predicted relapse at 6-month follow-up, and were associated with less favorable psychosocial functioning at post-therapy and at 6-month follow-up. Limitations: The study consisted of post-hoc analyses of existing data, the number of asymptomatic patients was small, and a proxy measure of relapse was used. Conclusions: Residual symptoms are prevalent among depressed patients who successfully respond to psychotherapy. Greater residual symptoms appear to increase the risk for relapse and are associated with poorer psychosocial functioning. (C) 2004 Elsevier B.V. All rights reserved.