Reducing Relapse in Depression and Anxiety: How Psychological Interventions Provide Long-Term Protection

Psychological Interventions to Prevent Relapse in anxiety and depression: A systematic review and meta-analysis

PLoS ONE 2022

Anxiety and depression are recognized as a major public health challenge, affecting approximately 615 million people worldwide. Relapse rates following remission are as high as 58% for anxiety and 77% for depression. Psychological relapse prevention techniques have been found to greatly reduce the likelihood of relapse in depression - while relapse prevention in anxiety needs further study.

The methods of relapse prevention studied include three kinds of cognitive therapy: cognitive behavioral therapy (CBT), cognitive therapy (CT), and mindfulness-based cognitive therapy (MBCT).  All were found to be helpful for patients with Major Depressive Disorder.

This study shows that psychological relapse prevention reduces the risk of relapse within 2 years by 24% on average as compared to treatment as usual.  There is also evidence that the benefits last beyond 2 years, though that evidence could be more robust.

Psychological relapse prevention should be considered for all depressed patients, as it dramatically reduces the likelihood of relapse - and those effects are even stronger with patients who have an exceptionally high risk of relapse.

Highlights from the Study

“For patients with remitted major depressive disorder, psychological interventions reduced the risk of relapse by 24% on average as compared to treatment as usual. . .”

“... patients receiving psychological interventions had 17% less risk of relapse than patients receiving maintenance antidepressant medication.”

“Although we might assume that the effect of psychological interventions decreases as follow up time increases, the studies with a mean follow-up duration of over 3 years indicated that psychological interventions still appear to protect against relapse when compared to treatment as usual.”

At Feeling Good Institute, we discuss relapse early in treatment and create robust relapse plans that include a variety of cognitive behavioral therapy techniques with our patients before terminating treatment.  

Research Brief Author:  LJ Davis, MA, LPC, LPCC, LCMHC
 

Citation: Krijnen-de Bruin E, Scholten W, Muntingh A, Maarsingh O, van Meijel B, van Straten A, et al. (2022) Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis. PLoS ONE 17(8): e0272200. https://doi.org/10.1371/journal.pone.0272200