For patients in remission from major depressive disorder (MDD), cognitive behavioral therapy (CBT) is an effective intervention for relapse prevention at either short- or long-term follow-up, according to results from a study published in BMC Psychiatry.

Zuojie Zhang, from the Department of Pharmacy, West China Second Hospital at Sichuan University in Chengdu, and colleagues conducted a review to evaluate the efficacy of CBT for reducing relapse of MDD by using databases from 1976 to September 1, 2016.

Patients were aged 18 years and older with MDD in full or partial remission based on a strict diagnostic definition. All CBT and modifications (such as CBT, cognitive therapy [CT], behavioral therapy [BT], Cognitive Behavioral Analysis System of Psychotherapy [CBASP], and MBCT) were deemed useful and included in the study.

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A total of 16 eligible trials involving 1,945 participants were analyzed. In the first 12 months, CBT was more efficacious than control (treatment as usual) in reducing the risk of developing a new episode of depression for MDD patients in remission (HR, 0.50). Mindfulness-based cognitive therapy (MBCT) was more efficacious than control only among patients with 3 or more previous depressive episodes (HR, 0.46). Compared with maintenance antidepressant medication (m-ADM), MBCT was a more effective intervention (HR, 0.76). These positive effects may be only maintained at 2 and nearly 6 years follow-up for CBT.

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“For short-term follow-up (12 months), our meta-analyses demonstrated that CBT was more efficacious in reducing the risk of developing a new relapse of depression than control,” stated the authors. “While compared to control, MBCT only showed a significant effect in patients with 3 or more previous depressive episodes.”


Zhang Z, Zhang L, Zhang G, Jin J, Zheng Z. The effect of CBT and its modifications for relapse prevention in major depressive disorder: a systematic review and meta-analysis. BMC Psychiatry. 2018 Feb 23;18(1):50. doi: 10.1186/s12888-018-1610-5