Relapse and recurrence prevention in depression: current research and future prospects.
There is a growing body of literature which indicates that acute phases of psychotherapy are often ineffective in preventing relapse and recurrence in major depression. As a result, there is a need to develop and evaluate therapeutic approaches which aim to reduce the risk of relapse. This article provides a review of the empirical studies which have tested the prophylactic effects of therapy (cognitive-behavioral, mindfulness-based, and interpersonal psychotherapy) targeting relapse and recurrence in major depression. For definitional clarity, relapse is defined here as a return to full depressive symptomatology before an individual has reached a full recovery, whereas recurrence in defined as the onset of a new depressive episode after a full recovery has been achieved. Psychotherapeutic efforts to prevent relapse and recurrence in depression have been effective to varying degrees, and a number of variables appear to moderate the success of these approaches. A consistent finding has been that preventive cognitive-behavioral and mindfulness-based therapies are most effective for patients with three or more previous depressive episodes, and alternative explanations for this finding are discussed. It is noted, however, that a number of methodological limitations exist within this field of research, and so a set of hypotheses that may guide future studies in this area is provided.
Department of Psychology, University of Calgary, Alberta, Canada. sbeshai@ucalgary.ca
Shadi
S
Beshai
Keith S
KS
Dobson
Claudi L H
CL
Bockting
Leanne
L
Quigley
D003865:Major Depressive Disorder / Q000517:prevention & control* / Q000628:therapy*; D005544:Forecasting; D006801:Humans; D011613:Psychotherapy / Q000379:methods* / Q000639:trends*; D055502:Secondary Prevention