Sudden gains in Cognitive Therapy and Interpersonal Psychotherapy for adult depression

•We examined sudden gains (SGs) in a randomized comparison of CT vs IPT for MDD.•There were significantly more patients with SGs in CT as compared to IPT.•No differences were found with regard to magnitude, timing and predictors of SGs.•Those with SGs were less depressed at post-treatment and remained so 5 months later.•The duration of the between-session interval did not influence the results.

ObjectiveWe examined the rates, baseline predictors and clinical impact of sudden gains in a randomized comparison of individual Cognitive Therapy (CT) and Interpersonal Psychotherapy (IPT) for adult depression.Method117 depressed outpatients received 16–20 sessions of either CT or IPT. Session-by-session symptom severity was assessed using the BDI-II. Sudden gains were examined using the original criteria as defined by Tang and DeRubeis (1999b). Furthermore, we examined whether the duration of the between-session interval at which sudden gains were recorded affected the results.ResultsThere were significantly more patients with sudden gains in CT (42.2%) as compared to IPT (24.5%). The difference appeared to be driven by the criterion representing the stability of the gain. No between-group differences were found with regard to the magnitude, timing and predictors of the gains. Those with sudden gains were less depressed at post-treatment and follow-up. After controlling for the duration of the between-session interval, the difference in rates between the two conditions became a non-significant trend. Other sudden gains characteristics were similar to those observed when allowing for longer intervals as well.ConclusionsThe current study indicates differences in occurrence of sudden gains in two treatment modalities that overall showed similar results, which might reflect different mechanisms of change.