Topic
Subsequent Relapse
About: Subsequent Relapse is a research topic. Over the lifetime, 407 publications have been published within this topic receiving 20677 citations.
Papers published on a yearly basis
Papers
TL;DR: MBCT is an effective and efficient way to prevent relapse/recurrence in recovered depressed patients with 3 or more previous episodes and in patients with only 2 episodes, suggesting that these groups represented distinct populations.
Abstract: Recovered recurrently depressed patients were randomized to treatment as usual (TAU) or TAU plus mindfulness-based cognitive therapy (MBCT). Replicating previous findings, MBCT reduced relapse from 78% to 36% in 55 patients with 3 or more previous episodes; but in 18 patients with only 2 (recent) episodes corresponding figures were 20% and 50%. MBCT was most effective in preventing relapses not preceded by life events. Relapses were more often associated with significant life events in the 2-episode group. This group also reported less childhood adversity and later first depression onset than the 3-or-more-episode group, suggesting that these groups represented distinct populations. MBCT is an effective and efficient way to prevent relapse/recurrence in recovered depressed patients with 3 or more previous episodes. Cognitive– behavioral therapy (CBT) for depression (Beck, Rush, Shaw, & Emery, 1979) administered during depressive episodes is effective in reducing subsequent relapse and recurrence. Patients who recover following treatment of acute depression by CBT subsequently show less relapse or need for further treatment than do patients who recover following treatment with antidepressant medication and are then withdrawn from medication (Blackburn, Eunson, & Bishop, 1986; Evans et al., 1992; Shea et al., 1992; Simons, Murphy, Levine, & Wetzel, 1986). As a result of CBT, patients presumably acquire skills, or changes in thinking, that confer some protection against future onsets. A recent approach of combining treatment of the acute episode by antidepressant medication with provision of CBT following recovery, while antidepressant medication is gradually withdrawn, has yielded preliminary successful findings in preventing relapse/ recurrence (Fava, Grandi, Zielezny, Canestrari, & Morphy, 1994; Fava, Grandi, Zielezny, Rafanelli, & Canestrari, 1996; Fava, Rafanelli, Grandi, Canestrari, & Morphy, 1998). The strategy of combining acute pharmacotherapy with psychological prophylaxis has the advantage of capitalizing on the cost-efficiency of antidepressant medication to reduce acute symptoms while reducing the need for patients to remain indefinitely on maintenance medication to prevent future relapse and recurrence. This strategy has also been evaluated using a novel, theory-driven approach to psychological prophylaxis, mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2002), formerly called attentional control (mindfulness) training. An initial evaluation of MBCT (Teasdale et al., 2000) demonstrated encouraging prophylactic effects. The present study examined the replicability of those findings and explored a number of related issues. MBCT was derived from a model of cognitive vulnerability to depressive relapse (Segal, Williams, Teasdale, & Gemar, 1996; Teasdale, 1988; Teasdale, Segal, & Williams, 1995) that assumes that individuals who have previously experienced episodes of major depression differ from those who have not in the patterns of negative thinking that become activated in mildly depressed mood. Specifically, it is assumed that in recovered depressed patients, compared with never-depressed controls, dysphoria is more likely to activate patterns of self-devaluative depressogenic thinking, similar to those that prevailed in preceding episodes. Considerable
1,522 citations
TL;DR: An information-processing analysis of depressive maintenance and relapse is used to define the requirements for effective prevention, and to propose mechanisms through which cognitive therapy achieves its prophylactic effects.
1,473 citations
TL;DR: There remains a substantial proportion of patients older than 60 years who do not receive intensive chemotherapy, but there is considerable interest in developing new treatments for this patient group, including novel nucleoside analogs and several other agents.
Abstract: The choice of treatment approach and outcome in acute myeloid leukemia (AML) depends on the age of the patient. In younger patients, arbitrarily defined as being younger than 60 years, 70% to 80% enter complete disease remission with several anthracycline-based chemotherapy combinations. Consolidation with high-dose cytarabine or stem-cell transplantation in high-risk patients will restrict overall relapse to approximately 50%. A number of demographic features can predict the outcome of treatment including cytogenetics and an increasing list of molecular features (ie, FLT3, NPM1, MLL, WT1, CEBPalpha, EVI1). These are increasingly being used to direct postinduction therapy, but they are also molecular targets for a new generation of small molecule inhibitors that are in early development; however, randomized data have yet to emerge. In older patients who comprise the majority, which will increase with demographic change, the initial clinical decision to be made is whether the patient should receive an intensive or nonintensive approach. If the same anthracycline/cytarabine-based approach is deployed, the remission rate will be around 50%, but the risk of subsequent relapse is approximately 85% at 3 years. This difference from younger patients is explained partly by the ability of patients to tolerate effective therapy, and also the aggregation of several poor risk factors compared with the young. There remains a substantial proportion of patients older than 60 years who do not receive intensive chemotherapy. Their survival is approximately 4 months, but there is considerable interest in developing new treatments for this patient group, including novel nucleoside analogs and several other agents.
795 citations
TL;DR: The Oklahoma TTP Registry is a population-based inception cohort of all 376 consecutive patients with an initial episode of clinically diagnosed TTP, and ADAMTS13 deficiency during remission was not clearly related to subsequent relapse.
565 citations
TL;DR: The findings lend support to a model of cessation in which level of motivation to stop generates quit attempts but plays little role in relapse, and Dependence, social smoking cues, and a recently failed quit attempt are important factors in relapse.
527 citations
Related Topics (5)
Performance Metrics
| Year | Papers |
|---|---|
| 2022 | 1 |
| 2021 | 18 |
| 2020 | 19 |
| 2019 | 15 |
| 2018 | 11 |
| 2017 | 18 |