Psychosocial Therapy Provides Lasting Protection from Depression Relapse

Treatments for depression vary widely. Some individuals with depression receive therapeutic interventions such as cognitive behavioral therapy (CBT), mindfulness therapy, or other psychosocial treatments. Others are prescribed pharmacological remedies such as antidepressants. Some people with depression receive both therapy and medication.

Although both methods have been shown to be effective at treating acute depression and decreasing symptoms in the short-term, it is unclear which method works best at providing long-term protection from depression relapse. Therefore, Pim Cuijpers of the Department of Psychology at the VU University Amsterdam in the Netherlands wanted to compare the enduring effects of both treatments.

Using nine studies involving over 500 participants, Cuijpers analyzed data on short-term efficacy of CBT and medication for acute depression by seeing which worked better when administered only for a brief period of time. Then Cuijpers compared the long-term effects of both. Finally, data was assessed to determine if acute CBT that was continued during a 12-month period was better at preventing relapse than acute medication that was discontinued.

The results revealed that there were significant differences in relapse rates depending on treatment type. “Patients who received acute phase CBT were significantly less likely to relapse than patients who were withdrawn from pharmacotherapy,” said Cuijpers. Further, although there were no large differences in relapse between acute CBT and continued medication treatment, the participants who received brief CBT had slightly lower rates of relapse than those who continued medication without CBT.

This suggests that CBT and other psychosocial interventions provide long-lasting protection from relapse via behavior and emotional changes. Specifically, these techniques empower individuals with awareness, knowledge, and tools they need to address emotional challenges in the future. Rather than reverting to prior thought processes, people at risk for depression can use these new skills to overcome negative thinking and negative mood states. In sum, these findings suggest that although long-term therapy may be the best prevention against relapse, even short-term therapy administered during the acute phase of depression may provide long-lasting protection from relapse.

Reference:
Cuijpers, P., Hollon, S.D., van Straten, A., et al. (2013). Does cognitive behavior therapy have an enduring effect that is superior to keeping patients on continuation pharmacotherapy? A meta-analysis. BMJ Open 2013;3:e002542. doi:10.1136/bmjopen-2012-002542

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  • nathan

    nathan

    June 24th, 2013 at 10:40 PM

    this makes so much sense.one changes your mind in that your mind is the most important player for depression.and another gives something external to your body,discontinuance of which could pave way for a relapse.this is true for most issues but especially true for depression.

  • Wesley

    Wesley

    June 25th, 2013 at 4:01 AM

    There are many of these types of treatments that go a long way toward empowering the patient, letting him know that somewhere in him there is the strength to fight this and to win. I think that a lot of times the patients who struggle with depression, they give up on life because it feels so hard to continue to fight those depressed feelings. But I think that something like CBT gives them the knowledge and the tools to see that they are stronger then this, that they can fight this, and this does not have to be something that has to consume all of their life. Just giving them that bit of hope is often enough to give them the will to fight against it instead of fold to it.

  • gennifer

    gennifer

    June 26th, 2013 at 4:04 AM

    Kind of confused that almost side by side we have one article stating that the skills learned in theapy can help prevent relapses, and another stating that life skills learned in therapy really don’t lead to any greater chance that you will never relapse. What’s up with that? Conflicting information for readers

  • lf

    lf

    June 26th, 2013 at 10:34 AM

    @gennifer, I think it has less to do with the articles and more to do with just how arbitrary some of these studies are. At the same moment that someone is publishing a study that produces positive results, someone is setting out to prove the opposite. There are so many ways of skewing research to fit one’s own agenda.

    In the case of the two articles you’re talking about, they’re each addressing different types of therapy, so technically they’re not contradictory. But I understand the confusion and agree that they don’t paint a uniform picture.

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