Treatment of Chronic Major Depression and Assessment Across Treatment and Follow-Up in an Elderly Female

Despite its need for greater understanding, the psychotherapy of long-term major depression and assessment of changes across therapy, relapse, and recovery are only sparsely covered in the literature. The current case study describes the cognitive-behavioral treatment of an older female with chronic major depression, with particular emphasis upon strategies for maintenance and relapse prevention. Between beginning and end of treatment, BDI-SF (short form), GDS, and Ham-D scores all decreased considerably, while SADS diagnosis improved. Breakdown of the patient's BDI-SF scores indicated that cognitive, behavioral, and affective domains exhibited different rates of change over the course of therapy and differential involvement in relapse during follow-up. Results of this study suggest that longitudinal collection of data from these domains may provide quite useful feedback regarding change rates, case conceptualization, and the symptomatology of depression and its relapse.