[Cognitive-behavioral therapy in prevention of depression relapses and recurrences: a review].
OBJECTIVE
To revise theories and the available evidence about Cognitive Behavioral Therapy (CBT) role on the relapse and recurrence prevention of depressive episodes.


METHODS
Review of random and controlled clinical trials that investigated CBT efficacy on the relapse and recurrence prevention of depressive episodes. The following databases were used: Medline, Lilacs, Cochrane, Biosis and Embase. The reference sections of the selected articles, review articles and specialized books were consulted.


RESULTS
Fifteen studies with different experimental design were found, several with methodological problems. The majority of them compared CBT with antidepressants at the acute treatment phase. In 12 studies CBT significantly lowered the relapse/recurrence rate. Recent papers pointed to the CBT usefulness for treating residual depressive symptoms as a recurrence prevention strategy.


CONCLUSIONS
CBT was effective for the depression relapse reduction. Its relationship with antidepressants as a prevention tool and CBT strategies (using it only in the acute phase, or during acute and maintenance phases, or after antidepressants withdrawal as a maintenance treatment, or focusing residual symptoms) need to be better investigated.
Departamento de Psiquiatria, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil. alexma@usp.br
Alexander Moreira de
AM
Almeida
Francisco
F
Lotufo Neto
D000928:Antidepressive Agents / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000592:standards*; D003866:Depressive Disorder / Q000188:drug therapy / Q000517:prevention & control*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention
D000928:Antidepressive Agents