The DOI matches its Crossref record; 68 of the 70 references it cites were found in a registry or an index, and 2 are not checked yet; none of the 40 sources its claims cite is checked for support yet.
Predictors of depression relapse and recurrence after cognitive behavioural therapy: a systematic review and meta-analysis
Abstract
Background: Cognitive behavioural therapy (CBT) is an effective psychological treatment for major depressive disorder, although some patients experience a return of symptoms after finishing therapy. The ability to predict which individuals are more vulnerable to deterioration would allow for targeted interventions to prevent short-term relapse and longer-term recurrence. Aim: This systematic review and meta-analysis aimed to identify factors associated with an increased risk of relapse and/or recurrence (RR) after CBT for depression. Method: We reviewed 13 relevant papers, of which a small set of unique samples were eligible for meta-analysis (k= 5,N= 369). Twenty-six predictor variables were identified and grouped into seven categories: residual depressive symptoms; prior episodes of depression; cognitive reactivity; stressful life events; personality factors; clinical and diagnostic factors; demographics. Results: Meta-analyses indicated that residual depressive symptoms (r= 0.34 [0.10, 0.54],p= .01) and prior episodes (r= 0.19 [0.07, 0.30],p= .002) were statistically significant predictors of RR, but cognitive reactivity was not (r= 0.18 [−0.02, 0.36],p= .08). Other variables lacked replicated findings. On average, 33.4% of patients experienced RR after CBT. Conclusions: Patients with the above risk factors could be offered evidence-based continuation-phase interventions to enhance the longer-term effectiveness of CBT.
Checked 2026-10-10 · 2 references not checked yet
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This systematic review and meta-analysis found that residual depressive symptoms and prior episodes of depression significantly predicted relapse and/or recurrence (RR) after acute-phase CBT, whereas cognitive reactivity did not. On average, 33.4% of patients experienced RR after CBT.
Key findings
- In random-effects meta-analyses, residual depressive symptoms were a moderate predictor of RR (r = 0.34 [0.10, 0.54], p = .01) and prior episodes were a small predictor (r = 0.19 [0.07, 0.30], p = .002); cognitive reactivity was not statistically significant (r = 0.18 [−0.02, 0.36], p = .08).
- Reported RR rates ranged from 18.5% to 46.5% after acute-phase CBT, with an average of 33.4% events within a maximum follow-up of 36 months; CBT-alone studies had a mean RR rate of 29.1%, and studies grouping treatments had a mean of 28.6%.
- Other predictors were mostly single-study findings: childhood maltreatment (OR = 2.89), dependent chronic stressors (OR = 1.34), severe independent life event post-treatment (OR = 1.03), intake anxiety (OR = 1.08), subclinical psychotic experiences (OR = 3.85), and subthreshold bipolar symptoms (OR = 1.16).
- Heterogeneity was high for residual depressive symptoms (I² = 85.3%) but not for prior episodes (I² = 0.0%); fail-safe N values were 72 for residual symptoms, 9 for prior episodes, and 7 for cognitive reactivity.
Methods
- Systematic review and random-effects meta-analysis; protocol registered in PROSPERO. Searches of Web of Science, PubMed, PsycINFO, and Scopus (January 1990–March 2017) returned 275 unique titles/abstracts; 59 full texts were assessed, and 13 articles were included (9 RCTs, 4 longitudinal cohort studies; total pooled sample N = 1219).
- Eligible studies included adults with unipolar major depressive disorder who completed acute-phase CBT without continuation-phase interventions, were published in peer-reviewed English-language journals, had follow-up of at least 6 months, and investigated predictors of RR.
- Meta-analysis was restricted to predictors examined in two or more studies with sufficient statistics; inferential statistics were converted to correlation coefficients (r), with heterogeneity assessed using Q and I², publication bias examined via funnel plot asymmetry tests, and fail-safe N calculated. The meta-analysis included k = 5, N = 369.
Limitations
- The paper states that at least half of the reviewed studies used arbitrary or unconventional operational definitions of relapse, making it impossible to clearly disentangle predictors of relapse versus recurrence.
- The paper states that most primary studies were underpowered: the largest number of RR events was 40 and the mean was 19, whereas detecting a medium effect would require 212 participants (64 RR cases) and a small effect 1310 participants (393 RR cases); over half of studies only reported significant results, suggesting possible selective reporting.
- The paper states that exclusions of grey literature, non-English publications, children and young people, and continuation-phase studies limit the review, and the small number of included studies precluded subgroup and moderator analyses; evident from the text, the meta-analyses rested on only five studies and high heterogeneity was present for residual depressive symptoms.
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Claims the paper makes
33 Not checked yet · 23 Own result · 22 Own method · 8 Own interpretation · 3 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“An important discrepancy is that no single or consistent cut-off was used across studies to demarcate relapse and recurrence events.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, after conducting a Pearson ' s correlation between RR rates and follow-up duration, we found no significant association ( r = 0.46, p = 0.16).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As shown in Table 1, the cut-off period (from the time of remission of symptoms) to define ' relapse ' events varied from 4 up to 24 months across different studies, thus blurring the boundaries between these clinical phenomena.”
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pooled effect was not statistically significant; r = 0.18 ( -0.02, 0.36), p = .08.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pooled effect was statistically significant, denoting a moderate correlation between residual depressive symptoms and RR; r = 0.34 (95% CI 0.10, 0.54), p = .01.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The pooled effect was statistically significant, denoting a small correlation between prior depression episodes and RR; r = 0.19 (0.07, 0.30), p = .002.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was an average of 33.4% events within a maximum follow-up period of 36 months.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The reported rates of depressive RR varied between studies, ranging from 18.5 to 46.5% after acute-phase CBT.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only four variables were consistently assessed as potential predictors of RR in more than one study (residual depressive symptoms, prior episodes, cognitive reactivity, marital status).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“This was particularly the case for most personality factors, demographics, stressful life events, and clinical and diagnostic factors.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As shown in Table 1, at least half of the reviewed studies applied arbitrary or unconventional operational definitions of relapse, which made it impossible to clearly disentangle predictors of relapse versus recurrence events.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our meta-analysis does not support this assertion, as the pooled correlation between cognitive reactivity and RR was not significant, and there was no evidence of significant heterogeneity in the sample of included studies.”
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, we found no evidence of potential publication bias, and the failsafe N calculations for each of these predictors (72 and 9) indicated that numerous studies with null findings would be needed to overturn these results.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our meta-analytic results indicated statistically significant and moderate correlations ( r = 0.34 and r = 0.19) between each of these variables and the risk of RR.”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our meta-analysis does not support this assertion, as the pooled correlation between cognitive reactivity and RR was not significant, and there was no evidence of significant heterogeneity in the sample of included studies.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, we found no evidence of potential publication bias, and the failsafe N calculations for each of these predictors (72 and 9) indicated that numerous studies with null findings would be needed to overturn these results.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, at least 30% of patients were found to experience RR (relapse and/or recurrence) after acute-phase CBT, confirming that depression is a refractory condition, particularly for patients with prior episodes and with residual depressive symptoms at the end of treatment.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“It is clear that depression is a highly refractory condition, with approximately one-third of patients having a clinically significant deterioration of symptoms after CBT.”
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The small number of studies ( ≤ 5) entered into meta-analysis precluded more detailed sub-group or moderator analyses.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Due to the nature of the studies included in this review, there is a high risk of bias towards concealment as participants would be aware if they were receiving CBT or pharmacotherapy, as would the therapist(s) administering the treatment.”
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Most of the studies did not provide sufficient information to assess whether there was a risk of bias due to randomization. Most studies lacked a detailed description of the randomization procedures.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“It was not possible to apply meta-analytic methods for numerous potential variables due to under-reporting of statistical information or lack of replication in multiple studies.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no significant evidence of heterogeneity; Q = 2.64, d.f. = 3, p = 0.45; I 2 = 0.0% (95% CI 0.0, 82.6).”
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“High levels of intake anxiety (pre-treatment) on the Beck Anxiety Inventory (BAI; Beck et al. , 1988) predicted a shorter time to RR after completing treatment (OR = 1.08), but post-treatment anxiety levels did not predict RR (Forand and DeRubeis, 2013).”
What the sources say
- Not checked yetcites Forand and DeRubeis, 2013
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no significant evidence of heterogeneity; Q = 6.81, d.f. = 3, p = 0.08; I 2 = 56.0% (95% CI 0.0, 85.4).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“High levels of intake anxiety (pre-treatment) on the Beck Anxiety Inventory (BAI; Beck et al. , 1988) predicted a shorter time to RR after completing treatment (OR = 1.08), but post-treatment anxiety levels did not predict RR (Forand and DeRubeis, 2013).”
What the sources say
- Not checked yetcites Forand and DeRubeis, 2013
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There was evidence of considerable heterogeneity; Q = 27.27, d.f. = 4, p < 0.0001; I 2 = 85.3% (95% CI 67.6, 93.4).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Greater neuroticism scores on the Eysenck Personality Inventory -Neuroticism and Extroversion Scales (Eysenck, 1968) and greater scores of hopelessness on the Hopelessness Scale (Beck et al. , 1974) also significantly predicted RR (Evans et al. , 1992).”
What the sources say
- Not checked yetcites Evans et al. , 1992
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Attributional style was not found to be significantly associated with risk of RR (Evans et al. , 1992; Gollan et al. , 2006).”
What the sources say
- Not checked yetcites Evans et al. , 1992
- Not checked yetcites Gollan et al. , 2006
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Quiring et al. (2002) found that as time to treatment entry (time between the onset of depressive symptoms and the time when treatment begins) increased, time taken to RR also significantly increased.”
What the sources say
- Not checked yetcites Quiring et al. (2002)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“According to the fail-safe N, 72 null studies would be needed to overturn this meta-analytic result.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The regression ( t = 0.4729, d.f. = 3, p = 0.67) and rank correlation tests (Kendall ' s tau = 0.2000, p = 0.82) for funnel plot asymmetry were not statistically significant, indicating no evidence of likely publication bias.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Greater neuroticism scores on the Eysenck Personality Inventory -Neuroticism and Extroversion Scales (Eysenck, 1968) and greater scores of hopelessness on the Hopelessness Scale (Beck et al. , 1974) also significantly predicted RR (Evans et al. , 1992).”
What the sources say
- Not checked yetcites Evans et al. , 1992
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A dependent personality style on the Millon Clinical Multiaxial Inventory-II (Millon, 1987) and scoring low on the Pleasant Events Schedule (PES) (MacPhillamy and Lewisohm, 1982) representing low perceived pleasure post-treatment also predicted RR (Gollan et al. , 2006).”
What the sources say
- Not checked yetcites Gollan et al. , 2006
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A slower decrease in symptom scores (i.e. a longer time to treatment response) also significantly predicted a higher chance of RR (Thase et al. , 1992).”
What the sources say
- Not checked yetcites Thase et al. , 1992 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“A dependent personality style on the Millon Clinical Multiaxial Inventory-II (Millon, 1987) and scoring low on the Pleasant Events Schedule (PES) (MacPhillamy and Lewisohm, 1982) representing low perceived pleasure post-treatment also predicted RR (Gollan et al. , 2006).”
What the sources say
- Not checked yetcites Gollan et al. , 2006
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Non-significant diagnostic and clinical history features included: age at onset of disorder; duration of current episode; insidiousness of onset; presence of precipitant; previous treatment with tricyclics; history of hospitalization; suicidal ideation; history of suicide attempts; history of alcoholism; history of substance abuse; Research Diagnostic Criteria (RDC) depressive sub-type; double dep”
What the sources say
- Not checked yetcites Thase et al. , 1996
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Residual depressive symptoms and prior episodes have been previously cited as the most robust predictors of depressive RR (Burcusa and Iacono, 2007; Keller et al. , 1983; Kessing et al. , 2004; Mueller et al. , 1999).”
What the sources say
- Not checked yetcites Burcusa and Iacono, 2007
- Not checked yetcites Keller et al. , 1983
- Not checked yetcites Kessing et al. , 2004
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Chopra et al. (2008) found that levels of cortisol post-treatment interacted with patients ' number of prior episodes.”
What the sources say
- Not checked yetcites Chopra et al. (2008)
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As shown in Table 1, at least half of the reviewed studies applied arbitrary or unconventional operational definitions of relapse, which made it impossible to clearly disentangle predictors of relapse versus recurrence events.”
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Participants that presented symptoms of a sub-clinical psychotic experience measured by the Community Assessment of Psychic Experiences (CAPE; Brenner et al. , 2007) and sub-threshold bipolar symptoms measured on the Mood Disorders Questionnaire (MDQ) (Hirschfeld et al. , 2000) were also found to be significantly more prone to RR with odds ratios of 3.85 and 1.16, respectively (Wigman et al. , 201”
What the sources say
- Not checked yetcites Wigman et al. , 2014
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Participants that presented symptoms of a sub-clinical psychotic experience measured by the Community Assessment of Psychic Experiences (CAPE; Brenner et al. , 2007) and sub-threshold bipolar symptoms measured on the Mood Disorders Questionnaire (MDQ) (Hirschfeld et al. , 2000) were also found to be significantly more prone to RR with odds ratios of 3.85 and 1.16, respectively (Wigman et al. , 201”
What the sources say
- Not checked yetcites Wigman et al. , 2014
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“This fits with emerging studies that suggest that mood reactivity may be more relevant than cognitive reactivity in the prediction of RR (Lethbridge and Allen, 2008; Rucci et al. , 2011; van Rijsbergen et al. , 2013).”
What the sources say
- Not checked yetcites Lethbridge and Allen, 2008
- Not checked yetcites Rucci et al. , 2011
- Not checked yetcites van Rijsbergen et al. , 2013
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Thase et al. (1992) found that unmarried participants were more likely to experience RR; however, Evans et al. (1992) did not find marital status to be a significant predictor.”
What the sources say
- Not checked yetcites Evans et al. (1992)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Patients with high cortisol levels had similar rates of RR regardless of prior episodes, but patients with low cortisol levels with two or fewer prior episodes tended to have lower rates of RR.”
What the sources say
- Not checked yetcites Chopra et al. (2008)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“For example, according to Cohen ' s sample size estimation criteria (Cohen, 1992), a simple comparison of means (between cases that RR and those who do not) in a continuous predictor using ANOVA would require at least 26 RR cases to detect a large effect size with 80% power, and thus an overall sample of 85 if we assume a RR base rate of 30%.”
What the sources say
- Not checked yetcites Cohen, 1992
plainn = 26- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The small sample sizes across most of these studies means that they were highly likely to be underpowered to detect significant factors that may have a small to moderate effect on the risk of RR.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Patients with high cortisol levels had similar rates of RR regardless of prior episodes, but patients with low cortisol levels with two or fewer prior episodes tended to have lower rates of RR.”
What the sources say
- Not checked yetcites Chopra et al. (2008)
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“It is clear that depression is a highly refractory condition, with approximately one-third of patients having a clinically significant deterioration of symptoms after CBT.”
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the small number of included studies did not allow further sub-group and moderator analyses.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Studies using monthly post-treatment tracking of symptoms show that the majority (78%) of clinically significant deterioration events occur within the first 6 months after therapy, so this is a critical period to monitor response to psychological care (Delgadillo et al. , 2018).”
What the sources say
- Not checked yetcites Delgadillo et al. , 2018
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This potentially indicates increased risk of selective reporting.”
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Using these criteria, 212 participants (64 RR cases) would be necessary to detect a medium effect size and 1310 participants (393 RR cases) to detect a small effect size.”
What the sources say
- Not checked yetcites Cohen, 1992
plainn = 393- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Using these criteria, 212 participants (64 RR cases) would be necessary to detect a medium effect size and 1310 participants (393 RR cases) to detect a small effect size.”
What the sources say
- Not checked yetcites Cohen, 1992
hedgedn = 64- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“As others have argued (Scott et al. , 2003), adjunctive and continuation-phase interventions are costly, but gains in prevention tend to outweigh the costs of future episodes of care for people that experience RR, who are often more severely impaired with each subsequent episode.”
What the sources say
- Not checked yetcites Scott et al. , 2003
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Studies using monthly post-treatment tracking of symptoms show that the majority (78%) of clinically significant deterioration events occur within the first 6 months after therapy, so this is a critical period to monitor response to psychological care (Delgadillo et al. , 2018).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We therefore conclude that not even the largest of these studies was sufficiently powered to detect a medium effect size, and the fact that many studies analysed multiple variables further reduces our confidence in their suitability to reliably detect significant predictors of RR.”
plainn = 64- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We therefore conclude that not even the largest of these studies was sufficiently powered to detect a medium effect size, and the fact that many studies analysed multiple variables further reduces our confidence in their suitability to reliably detect significant predictors of RR.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 20
- The quote only partly states this claim. 4
- It may state two separate claims as one. 18
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Thirteen articles were identified as eligible for inclusion in the review.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Our meta-analytic results indicated statistically significant and moderate correlations ( r = 0.34 and r = 0.19) between each of these variables and the risk of RR.”
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
The quote only partly states this claim.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Several significant predictors were identified across studies; however, the majority were only tested in single studies and lacked replicated findings.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Indices of heterogeneity were high (I 2 = 85.3%) for residual depressive symptoms but not for prior episodes (I 2 = 0%).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Three variables, however, were examined across multiple studies that reported sufficient data to enable meta-analysis.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Many studies that were deemed ineligible for this review were well-designed controlled trials with adequate longitudinal follow-up periods; however, these did not quantify RR events or rates at follow-up.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, over half of the reviewed studies only reported significant results -there was no mention of variables that were non-significant predictors of RR in most of the studies.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Personality factors (e.g. neuroticism, hopelessness, perceived pleasure) predicted RR most frequently in the included studies, albeit in single studies.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“The largest number of subjects that experienced a RR event in the reviewed studies was 40 (Gollan et al. , 2006), whilst the mean was only 19.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The systematic review protocol was registered and published in the International Prospective Register of Systematic Reviews (PROSPERO) ahead of conducting the review (protocol ID: PROSPERO 2017:CRD42017057747).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Fifty-nine full-text articles were then assessed for eligibility independently by two reviewers; any disagreements were discussed and resolved by consensus.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“However, some patients are prone to RR after CBT as described in a review by Paykel (2007), where rates between studies ranged from 10 to 49%.”
What the sources say
- Not checked yetcites Paykel (2007)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no disagreements in results between the two independent reviewers.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Two reviewers extracted the data independently.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Cognitive behavioural therapy (CBT) is an increasingly available and effective psychological intervention, recommended as a first-line treatment in clinical guidelines for the management of depression (American Psychiatric Association, 2000b; National Institute for Health and Care Excellence, 2010).”
What the sources say
- Not checked yetcites American Psychiatric Association, 2000b
- Not checked yetcites National Institute for Health and Care Excellence, 2010
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The regression ( t = -0.8810, d.f. = 2, p = 0.47) and rank correlation tests (Kendall ' s tau = -0.33, p = 0.75) for funnel plot asymmetry were not statistically significant and the fail-safe N was 9.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The regression ( t = 1.40, d.f. = 2, p = 0.30) and rank correlation tests (Kendall ' s tau = 0.33, p = 0.75) for funnel plot asymmetry were not statistically significant and the fail-safe N was 7.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In Evans et al. (1992) and Forand and DeRubeis (2013), the authors of the paper are also the therapists within the study, potentially leading to researcher allegiance effects.”
What the sources say
- Not checked yetcites Evans et al., 1992
- Not checked yetcites Forand and DeRubeis, 2013
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“As is common in longitudinal studies, there were high rates of attrition.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Other demographic characteristics that were not associated with RR included age, gender, race, employment status, education, socioeconomic status, and intelligence (Evans et al. , 1992).”
What the sources say
- Not checked yetcites Evans et al. , 1992
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Thase et al. (1992) found that unmarried participants were more likely to experience RR; however, Evans et al. (1992) did not find marital status to be a significant predictor.”
What the sources say
- Not checked yetcites Thase et al. (1992) source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The quote only partly states this claim.
In the paper
“Non-significant diagnostic and clinical history features included: age at onset of disorder; duration of current episode; insidiousness of onset; presence of precipitant; previous treatment with tricyclics; history of hospitalization; suicidal ideation; history of suicide attempts; history of alcoholism; history of substance abuse; Research Diagnostic Criteria (RDC) depressive sub-type; double dep”
What the sources say
- Not checked yetcites Evans et al. , 1992
plain- Asserted: fails — The authors may not put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The authors may not put it forward as true. The paper’s conclusions may not depend on it. The paper may give no reason why it holds. It may state two separate claims as one. The quote only partly states this claim.
In the paper
“A third commonly cited predictor of depressive RR is cognitive reactivity as measured by the DAS following a mood induction procedure (Segal et al. , 1999, 2006).”
What the sources say
- Not checked yetcites Segal et al. , 1999, 2006
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, at least 30% of patients were found to experience RR (relapse and/or recurrence) after acute-phase CBT, confirming that depression is a refractory condition, particularly for patients with prior episodes and with residual depressive symptoms at the end of treatment.”
boostedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The present review had several strengths including the pre-registration of the study protocol; searches across multiple databases, reference lists and direct requisition to corresponding authors; double rating of included studies; and quantitative meta-analyses of available data.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“As others have argued (Scott et al. , 2003), adjunctive and continuation-phase interventions are costly, but gains in prevention tend to outweigh the costs of future episodes of care for people that experience RR, who are often more severely impaired with each subsequent episode.”
What the sources say
- Not checked yetcites Scott et al. , 2003
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The present review had several strengths including the pre-registration of the study protocol; searches across multiple databases, reference lists and direct requisition to corresponding authors; double rating of included studies; and quantitative meta-analyses of available data.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The present review had several strengths including the pre-registration of the study protocol; searches across multiple databases, reference lists and direct requisition to corresponding authors; double rating of included studies; and quantitative meta-analyses of available data.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“There are also well-established relapse prevention interventions that should be offered after patients have completed an acute-phase treatment, such as continuation-phase CBT (Vittengl et al. , 2007) and MBCT (Piet and Hougaard, 2011).”
What the sources say
- Not checked yetcites Vittengl et al. , 2007
- Not checked yetcites Piet and Hougaard, 2011
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“However, this review was limited by the exclusions imposed on grey literature, publications in languages other than English, studies in children and young people, and studies which included a continuation-phase procedure or intervention.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The present review had several strengths including the pre-registration of the study protocol; searches across multiple databases, reference lists and direct requisition to corresponding authors; double rating of included studies; and quantitative meta-analyses of available data.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
The paper relies on this without support.
No prior systematic review and quantitative synthesis of predictors of relapse/recurrence after CBT for depression exists.
“This study presents the first systematic review and quantitative synthesis of the literature on predictors of RR (relapse and/or recurrence) after CBT for depression.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“after treatment, a higher risk of relapse has been associated with the number and severity of previous episodes, the persistence of residual symptoms and a history of childhood maltreatment.9,15,19–23”
Experimental — accuracy not yet measuredIn the citing paper
“This is consistent with other studies where few clinical factors predicted relapse in patients after treatment for MDD.15,20–23”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Predictors of RR · p. 8
“Only four variables were consistently assessed as potential predictors of RR in more than one study (residual depressive symptoms, prior episodes, cognitive reactivity, marital status).”
§ Personality factors · p. 11
“Attributional style was not found to be significantly associated with risk of RR (Evans et al. , 1992; Gollan et al. , 2006).”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Rates of RR · p. 8
“The reported rates of depressive RR varied between studies, ranging from 18.5 to 46.5% after acute-phase CBT.”
§ Sequence generation · p. 7
“Harkness et al. (2014) | 108 | Both | < 4 m of remission | 2/22(9)”
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Abstract · p. 2
“Twenty-six predictor variables were identified and grouped into seven categories: residual depressive symptoms; prior episodes of depression; cognitive reactivity; stressful life events; personality factors; clinical and diagnostic factors; demographics.”
§ Predictors of RR · p. 8
“Studies included in this review investigated 62 variables as potential predictors of relapse.”
Citations
Cites
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & for the PRISMA Group (2009) · BMJ · doi:10.1136/bmj.b2535 · Cited by 83,823
Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement
Moher, D., Liberati, A., Tetzlaff, J., Altman, D. G., & The PRISMA Group (2009) · PLoS Medicine · doi:10.1371/journal.pmed.1000097 · Cited by 64,042
Measuring inconsistency in meta-analyses
Higgins, J. P. T., Thompson, S. G., Deeks, J. J., & Altman, D. G. (2003) · BMJ · doi:10.1136/bmj.327.7414.557 · Cited by 63,139
Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement.
(2009) · PubMed Central · Cited by 44,859
An inventory for measuring depression
BECK, A. T. (1961) · Archives of General Psychiatry · doi:10.1001/archpsyc.1961.01710120031004 · Cited by 38,032
The Cochrane Collaboration's tool for assessing risk of bias in randomised trials
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Lam, R. W. M., Kennedy, S. H., Adams, G. C., Bahji, A., Beaulieu, S., Bhat, V., Blier, P., Blumberger, D. M., Brietzke, E. M., Chakrabarty, T., et al. (2024) · The Canadian Journal of Psychiatry · doi:10.1177/07067437241245384 · Cited by 435
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Self-citationA meta-analysis of relapse rates in cognitive-behavioral therapy for anxiety disorders
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Metadata
- Authors
- Wojnarowski, C., Firth, N., Finegan, M., & Delgadillo, J.
- Affiliations
- University of Sheffield (GB)
- Corresponding author
- Wojnarowski, Caroline
- Venue
- Behavioural and Cognitive Psychotherapy
- Publisher
- Cambridge University Press (CUP)
- Published
- 2019-03-21
- Volume
- 47
- Issue
- 5
- Pages
- 514-529
- ISSN
- 1352-4658 (ISSN-L)
- 1469-1833
- OpenAlex
- W2906420156
- Semantic Scholar
- 1e09ba2efd15d1e8d6e17722669310f81e5613bc
- Cited by
- 108
- References
- 69
- Citations by year
- 2026: 13 · 2025: 16 · 2024: 11 · 2023: 20 · 2022: 12 · 2021: 22 · 2020: 10 · 2019: 4
- FWCI
- 1.79
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioural and Cognitive Psychotherapy (publishedVersion)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- cognitive behavioral therapy, major depressive disorder, depression relapse, depression recurrence, predictors of relapse, residual depressive symptoms, cognitive reactivity, life events, personality factors
- MeSH terms
- Depression, Major Depressive Disorder, Humans, Prognosis, Recurrence, Risk Factors, Cognitive Behavioral Therapy, Treatment Outcome
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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