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Reducing relapse and recurrence in unipolar depression: a comparative meta-analysis of cognitive-behavioral therapy’s effects
Open accessAbstract
Relapse and recurrence following response to acute-phase treatment for major depressive disorder (MDD) are prevalent and costly. In a meta-analysis of 28 studies including 1,880 adults, the authors reviewed the world's published literature on cognitive-behavioral therapies (CT) aimed at preventing relapse-recurrence in MDD. Results indicate that after discontinuation of acute-phase treatment, many responders to CT relapse-recur (29% within 1 year and 54% within 2 years). These rates appear comparable to those associated with other depression-specific psychotherapies but lower than those associated with pharmacotherapy. Among acute-phase treatment responders, continuation-phase CT reduced relapse-recurrence compared with assessment only at the end of continuation treatment (21% reduction) and at follow-up (29% reduction). Continuation-phase CT also reduced relapse-recurrence compared with other active continuation treatments at the end of continuation treatment (12% reduction) and at follow-up (14% reduction). The authors discuss implications for research and patient care and suggest directions, with methodological refinements, for future studies.
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“However, numerous high-quality studies show that treatment effects wane and that the risk of relapse ranges from 29% to 51% in the first year after treatment completion 2-4 .”
From ChatGPT: five priorities for research (2023) · cites this paper as [4]
In the citing paper
“Meta-analyses focusing on psychological relapse prevention interventions for depressive disorders indicate that these interventions are effective in preventing relapse, with reductions of 22–50% in relapse [18, 44–48].”
From Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis (2022) · cites this paper as [47]
In the citing paper
“approximately 40%–50% of patients relapse within 1–2 years of receiving treatment (8, 9).”
From A narrative review of digital biomarkers in the management of major depressive disorder and treatment-resistant forms (2023) · cites this paper as [9]
In the citing paper
“Significantly, fewer participants receiving ICBT experienced relapse compared with those in the control group (10.5 compared with 37.8%), which is in line with previous face-to-face studies [30].”
From Internet-based psychological treatments for depression (2012) · cites this paper as [30]
In the citing paper
“A number of psychological interventions have been developed that can be used to target such cognitive change in remitted depressed individuals, most notably cognitive-behavior therapy (CBT; Vittengl, Clark, Dunn, & Jarrett, 2007) and mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2012).”
From Beneficial effects of training in self-distancing and perspective broadening for people with a history of recurrent depression (2017) · cites this paper as Vittengl, Clark, Dunn, & Jarrett, 2007
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“In fact, the perceived efficacy of CBT in all three disorders seems to rest principally onmetaanalysis, where it has been concluded, for example, that : ‘The positive results … can therefore be taken as confirming the promise of cognitive behavioural treatment in schizophrenia ’ (Pilling et al.…”
MethodBockting, C. L., Hollon, S. D., Jarrett, R. B., Kuyken, W., & Dobson, K. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.02.003 · Cited by 295
“In contrast to acute phase ADM treatment, some types of acute phase psychological interventions appear to have preventive effects for someperiod of time even after discontinuation (Cuijpers et al., 2013; Vittengl et al., 2007).”
BackgroundResultInfluentialSelf-citationCognitive Behavioral Therapy for Mood Disorders: Efficacy, Moderators and Mediators
Driessen, E., & Hollon, S. D. (2010) · Psychiatric Clinics of North America · doi:10.1016/j.psc.2010.04.005 · Cited by 291
“Among patients who respond to acute treatment, relapse rates are lower following treatment termination after acute CBT than after acute ADM and also lower for patients treated with combined treatment than for patients treated with ADM alone.(31) This finding suggests that it is not so much the withdrawal of medication…”
Emotion regulation predicts symptoms of depression over five years
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“risk of relapse after discontinuation of treatment [2].”
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Carr, A. (2018) · Journal of Family Therapy · doi:10.1111/1467-6427.12226 · Cited by 312
“Finally, research on adult depression has shown that relapse rates in the year following Alan Carr24 VC 2018 The Association for Family Therapy and Systemic Practice 176 pharmacotherapy are about double those of psychotherapy (Vittengl et al., 2007).”
BackgroundSteffens, N. K., LaRue, C. J., Haslam, C., Walter, Z. C., Cruwys, T., Munt, K. A., Haslam, S. A., Jetten, J., & Tarrant, M. (2021) · Health Psychology Review · doi:10.1080/17437199.2019.1669481 · Cited by 259
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“One earlier review examined whether the acute phase CBT had an enduring effect relative to medication withdrawal, but no direct comparison was made against continuation pharmacotherapy.(8) Since the continued prescription of pharmacotherapy is now the current standard of treatment and the key decision that clinicians…”
BackgroundThe effectiveness of family therapy and systemic interventions for child‐focused problems
Carr, A. (2008) · Journal of Family Therapy · doi:10.1111/j.1467-6427.2008.00451.x · Cited by 251
“Finally, research on adult depression has shown that relapse rates in the year following pharmacotherapy are about double those of psychotherapy (Vittengl et al., 2007).”
BackgroundChildhood Trauma and Its Relation to Chronic Depression in Adulthood
Negele, A., Kaufhold, J., Kallenbach, L., & Leuzinger-Bohleber, M. (2015) · Depression Research and Treatment · doi:10.1155/2015/650804 · Cited by 218
More treatment but no less depression: The treatment-prevalence paradox
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“…evidence to support the effi cacy of CBT in the maintenance treatment of major depression, either alone or in combination with antidepressants (Vittengl et al. 2007), with the effect size varying dependent on many variables, such as the control condition (Lynch et al. 2010; Stangier et al.…”
BackgroundChaves, C., Lopez-Gomez, I., Hervas, G., & Vazquez, C. (2017) · Cognitive Therapy and Research · doi:10.1007/s10608-016-9778-9 · Cited by 196
“Several follow-up studies have indicated that relapse and recurrence rates in depression remain high (Vittengl et al. 2007).”
BackgroundResultLorenzo-Luaces, L., German, R. E., & DeRubeis, R. J. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.12.003 · Cited by 190
Parikh, S. V., Segal, Z. V., Grigoriadis, S., Ravindran, A. V., Kennedy, S. H., Lam, R. W., & Patten, S. B. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.06.042 · Cited by 183
“However, stopping acute phase CBT results in a relapse rate of 54% within 2 years (Vittengl et al., 2007); therefore, metaanalysis also examined the impact of maintenance CBT, using those who had already responded to CBT.”
BackgroundMethodThe evidence base for family therapy and systemic interventions for child‐focused problems
Carr, A. (2014) · Journal of Family Therapy · doi:10.1111/1467-6427.12032 · Cited by 215
“Finally, research on adult depression has shown that relapse rates in the year following pharmacotherapy are about double those following psychotherapy (Vittengl et al., 2007).”
BackgroundHow to obtain nnt from cohen’s D: comparison of two methods
Furukawa, T. A., & Leucht, S. (2011) · PLoS ONE · doi:10.1371/journal.pone.0019070 · Cited by 179
“This NNT can therefore be interpreted as the number of patients one would need to treat with the intervention in order to have one more patient to have an outcome better than a randomly selected one in the control group than if the same number had been given the control intervention. This definition is clinically abst…”
MethodBiesheuvel-Leliefeld, K. E. M., Kok, G. D., Bockting, C. L. H., Cuijpers, P., Hollon, S. D., van Marwijk, H. W. J., & Smit, F. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.12.016 · Cited by 175
“Examples are the meta-analyses by Guidi et al. (2011), Vittengl et al. (2007) and Piet and Hougaard (2011), who conclude that (some types of) preventive psychological interventions after remission are effective in reducing relapse or recurrence.”
InfluentialDooley, L. N., Kuhlman, K. R., Robles, T. F., Eisenberger, N. I., Craske, M. G., & Bower, J. E. (2018) · Neuroscience & Biobehavioral Reviews · doi:10.1016/j.neubiorev.2018.09.006 · Cited by 176
Is Alpha Wave Neurofeedback Effective with Randomized Clinical Trials in Depression? A Pilot Study
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“the left hemisphere holds an advantage in processing positive emotional information, whereas the right hemisphere holds an advantage in processing negative emotional information. Decreased negative-biased processing associated with decreased right frontal activity (induced by neurofeedback) may diminish negative cogni…”
BackgroundStangier, U., Hilling, C., Heidenreich, T., Risch, A. K., Barocka, A., Schlösser, R., Kronfeld, K., Ruckes, C., Berger, H., Röschke, J., et al. (2013) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2013.12060734 · Cited by 174
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“It has also been recognized, however, that acute phase CT has enduring effects (Vittengl et al., 2007), which in some instances have been shown to be as potent as even a continued course of antidepressant medication.”
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“, 2015), and although many patients can benefit from depression treatments, relapse and recurrence rates even after a successful therapy are considerable (Vittengl et al., 2007).”
BackgroundThe effectiveness of family therapy and systemic interventions for adult‐focused problems
Carr, A. (2008) · Journal of Family Therapy · doi:10.1111/j.1467-6427.2008.00452.x · Cited by 146
“Also, in the year following treatment, relapse rates following pharmacotherapy are about double those of relapse rates following psychotherapy (65% vs. 29%, Vittengl et al., 2007).”
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“Meta-analyses of trials in this area show that accessing cognitive behavioural therapy (CBT) reduces the risk of depression relapse (Vittengl et al., 2007; Cuijpers et al., 2013) by comparison to acute-phase pharmacological treatment.”
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Improving the Efficiency of Psychotherapy for Depression: Computer-Assisted Versus Standard CBT
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Personalized Psychotherapy for Adult Depression: A Meta-Analytic Review
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“Comparable learning may not take place with pharmacotherapy alone (Pava et al. 1994 ; Segal et al. 2003 ; Vittengl et al. 2007).”
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Holländare, F., Johnsson, S., Randestad, M., Tillfors, M., Carlbring, P., Andersson, G., & Engström, I. (2011) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2011.01698.x · Cited by 111
“In another meta-analysis, almost onethird suffered a relapse within 1 year after cognitive behaviour therapy (CBT) (4).”
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“TAU + CT, 4 or more (n = 49) 40 (9, 0) 33 (16, 0) 29 (20, 0) 24 (25, 0) 17 (31, 1) 14 (33, 2) 13 (34, 2) 11 (36, 2) 11 (36, 2) 11 (36, 2) 1 (36, 12) TAU, fewer than 4 (n = 43) 33 (10, 0) 28 (15, 0) 20 (22, 1) 18 (23, 2) 15 (26, 2) 11 (28, 4) 10 (29, 4) 9 (30, 4) 9 (30, 4) 9 (30, 4) 0 (32, 11) TAU + CT, fewer than 4 (n…”
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“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).”
BackgroundZwerenz, R., Becker, J., Knickenberg, R. J., Siepmann, M., Hagen, K., & Beutel, M. E. (2017) · Psychotherapy and Psychosomatics · doi:10.1159/000481177 · Cited by 108
“Even though inpatient psychotherapy has been shown to improve depressive symptoms considerably [27–29] , patients do not fully remit within 4–8 weeks, and they are at an increased risk for relapse or readmission [30, 31] .”
BackgroundThe relationship between rumination, PTSD, and depression symptoms
Roley‐Roberts, M. E., Claycomb, M. A., Contractor, A. A., Dranger, P., Armour, C., & Elhai, J. D. (2015) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.04.006 · Cited by 114
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“There is strong evidence that even after successful pharmacologic or psychotherapeutic treatment of an acute episode of major depression, relapse and recurrence are common phenomena (Vittengl et al., 2007).”
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“Also, in the year following treatment, relapse rates following pharmacotherapy are about double those of relapse rates following psychotherapy (65% vs. 29%, Vittengl et al., 2007).”
BackgroundStress generation: Future directions and clinical implications
Liu, R. T. (2013) · Clinical Psychology Review · doi:10.1016/j.cpr.2013.01.005 · Cited by 102
Kennard, B. D., Emslie, G. J., Mayes, T. L., Nightingale-Teresi, J., Nakonezny, P. A., Hughes, J. L., Jones, J. M., Tao, R., Stewart, S. M., & Jarrett, R. B. (2008) · Journal of the American Academy of Child & Adolescent Psychiatry · doi:10.1097/chi.0b013e31818914a1 · Cited by 98
Self-citationConflicts of interest and the quality of recommendations in clinical guidelines
Cosgrove, L., Bursztajn, H. J., Erlich, D. R., Wheeler, E. E., & Shaughnessy, A. F. (2012) · Journal of Evaluation in Clinical Practice · doi:10.1111/jep.12016 · Cited by 98
“There is a well-documented evidence base for the efficacy of non-pharmacological interventions in the treatment of mild to moderate depression, particularly for exercise [55,56] and psychotherapy [57,58].”
BackgroundDon't Forget Your Body: Mindfulness, Embodiment, and the Treatment of Depression
Michalak, J., Burg, J. M., & Heidenreich, T. (2012) · Mindfulness · doi:10.1007/s12671-012-0107-4 · Cited by 117
“One of the most striking difficulties in the treatment of depression is that chronic and recurring types of depression are common phenomena (Hollon et al. 2005; Vittengl et al. 2007).”
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“For studies investigating relapse rates, Vittengl et al. (2007) suggest that researchers use “time to event” (survival) analyses to more accurately estimate relapse-recurrence rates and importantly, include sufficiently long follow-up periods that more accurately reflect the natural course of…”
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ten Doesschate, M. C., Koeter, M. W. J., Bockting, C. L. H., & Schene, A. H. (2010) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.04.026 · Cited by 91
“The poor outcome of rMDD in terms of HRQOL emphasizes the need for applying specific treatments on residual symptoms after remission (see for a review Vittengl et al. (2007)) and development of HRQOL enhancement therapies.”
Preventing Depressive Relapse and Recurrence in Higher-Risk Cognitive Therapy Responders
Jarrett, R. B., Minhajuddin, A., Gershenfeld, H. K., Friedman, E. S., & Thase, M. E. (2013) · JAMA Psychiatry · doi:10.1001/jamapsychiatry.2013.1969 · Cited by 87
Self-citationAdherence to continuation and maintenance antidepressant use in recurrent depression
ten Doesschate, M. C., Bockting, C. L. H., & Schene, A. H. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2008.07.011 · Cited by 86
Hennemann, S., Farnsteiner, S., & Sander, L. (2018) · Internet Interventions · doi:10.1016/j.invent.2018.09.001 · Cited by 86
“Meta-analytic evidence indicates the effectiveness of aftercare for mental disorders including psychotherapy (Carter et al., 2009; Vittengl et al., 2007), psychosocial interventions (Beynon et al.”
BackgroundA pilot randomised controlled trial of cognitive behavioural therapy for antenatal depression
Burns, A., O’Mahen, H., Baxter, H., Bennert, K., Wiles, N., Ramchandani, P., Turner, K., Sharp, D., Thorn, J., Noble, S., et al. (2013) · BMC Psychiatry · doi:10.1186/1471-244x-13-33 · Cited by 80
“This definition was based on the findings of a meta-analysis of CBT in preventing depression that found the strongest effect size in clinical trials offering more than 8 sessions [35].”
MethodThe Challenges of Improving Treatments for Depression
Cuijpers, P. (2018) · JAMA · doi:10.1001/jama.2018.17824 · Cited by 78
Titov, N., Dear, B. F., Johnston, L., McEvoy, P. M., Wootton, B., Terides, M. D., Gandy, M., Fogliati, V., Kayrouz, R., & Rapee, R. M. (2014) · PLoS ONE · doi:10.1371/journal.pone.0089591 · Cited by 81
Leichsenring, F., & Schauenburg, H. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.08.007 · Cited by 83
“…have only shown moderate efficacy with regard to relapse prevention, especially in long-term follow-ups of up to two years, not only for pharmacotherapy, but also for psychotherapy (Blackburn and Moore., 1997; Fava et al., 2004; Forand et al., 2013; Hollon et al., 2005; Vittengl et al., 2007).”
BackgroundThe Clinical Interview for Depression: A Comprehensive Review of Studies and Clinimetric Properties
Guidi, J., Fava, G. A., Bech, P., & Paykel, E. S. (2010) · Psychotherapy and Psychosomatics · doi:10.1159/000317532 · Cited by 78
Lokkerbol, J., Adema, D., Cuijpers, P. J., Reynolds, C. F., Schulz, R., Weehuizen, R., & Smit, F. (2013) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2013.01.058 · Cited by 78
“Our reanalysis of the meta-analysis by Vittengl et al.(33) See k.”
MethodEveraert, J., Vrijsen, J. N., Martin‐Willett, R., van de Kraats, L., & Joormann, J. (2022) · Psychological Bulletin · doi:10.1037/bul0000367 · Cited by 91
“Despite a range of therapeutic interventions, relapse, recurrence, and nonresponse rates remain high (Munder et al., 2019; Vittengl et al., 2007).”
BackgroundFarmer, R. F., & Chapman, A. L. (2008) · American Psychological Association eBooks · doi:10.1037/11664-000 · Cited by 74
Hagen, R., Hjemdal, O., Solem, S., Kennair, L. E. O., Nordahl, H. M., Fisher, P., & Adrian Wells, A. (2017) · Frontiers in Psychology · doi:10.3389/fpsyg.2017.00031 · Cited by 78
“Relapse rates are between 40 to 60% within a period of 2 years (Hollon et al., 2006; Vittengl et al., 2007).”
BackgroundBrush, C. J., Hajcak, G., Bocchine, A. J., Ude, A. A., Muniz, K. M., Foti, D., & Alderman, B. L. (2022) · Psychological Medicine · doi:10.1017/s0033291720002573 · Cited by 68
New Modalities of Assessment and Treatment Planning in Depression
Fava, G. A., & Tomba, E. (2010) · CNS Drugs · doi:10.2165/11531580-000000000-00000 · Cited by 76
Schmid, M. T., & Hammar, Å. (2013) · Frontiers in Psychology · doi:10.3389/fpsyg.2013.00633 · Cited by 77
“This is surprising, given that ∼50% of all patients are estimated to have a relapse within 2 years, with the highest risk during the first year after initial episode (Mueller et al., 1999; Vittengl et al., 2007).”
BackgroundAndrews, G., & Williams, A. D. (2014) · Clinical Psychology Review · doi:10.1016/j.cpr.2014.05.006 · Cited by 75
Jarrett, R. B., Minhajuddin, A., Borman, P. D., Dunlap, L., Segal, Z. V., Kidner, C. L., Friedman, E. S., & Thase, M. E. (2012) · Behaviour Research and Therapy · doi:10.1016/j.brat.2012.01.008 · Cited by 72
Self-citationHase, M., Balmaceda, U. M., Hase, A., Lehnung, M., Tumani, V., Huchzermeier, C., & Hofmann, A. (2015) · Brain and Behavior · doi:10.1002/brb3.342 · Cited by 72
“In fact, 1 year after discontinuation of psychotherapy for acute depression, the relapse rate was 29%, and increased to 54% after 2 years (Vittengl et al. 2007).”
BackgroundDunn, B. D., Widnall, E., Reed, N., Owens, C., Campbell, J., & Kuyken, W. (2019) · Behaviour Research and Therapy · doi:10.1016/j.brat.2019.103418 · Cited by 70
Patel, V., Weobong, B., Nadkarni, A., Weiss, H. A., Anand, A., Naik, S., Bhat, B., Pereira, J., Araya, R., Dimidjian, S., et al. (2014) · Trials · doi:10.1186/1745-6215-15-101 · Cited by 66
“Furthermore, PTs are associated with lower relapse rates when compared with antidepressant medication [7] and a recent UK trial demonstrated that adding PT to routine primary care for treatment-resistant depression greatly enhanced recovery rates [5].”
ResultManagement of depression in adults
Timonen, M., & Liukkonen, T. (2008) · BMJ · doi:10.1136/bmj.39478.609097.be · Cited by 72
“A recent systematic review and meta-analysis of four clinical trials (three randomised controlled trials) found that cognitive behaviour therapy during the continuation phase significantly reduced the rate of relapse and recurrence compared with controls who received assessment only. The efficacy of the therapy, based…”
ResultRodgers, M., Asaria, M., Walker, S., McMillan, D., Lucock, M. P., Harden, M., Palmer, S., & Eastwood, A. J. (2012) · Health Technology Assessment · doi:10.3310/hta16280 · Cited by 66
The Effect of Cognitive Behavioral Group Therapy for Depression: A Meta‐Analysis 2000–2010
Feng, C., Chu, H., Chen, C., Chang, Y., Chen, T., Chou, Y., Chang, Y., & Chou, K. (2012) · Worldviews on Evidence-Based Nursing · doi:10.1111/j.1741-6787.2011.00229.x · Cited by 66
Dunlop, B. W., LoParo, D., Kinkead, B. L., Mletzko, T., Cole, S. P., Nemeroff, C. B., Mayberg, H. S., & Craighead, W. E. (2019) · American Journal of Psychiatry · doi:10.1176/appi.ajp.2018.18091075 · Cited by 69
“The protective effect of CBT against recurrence is particularly evident if the antidepressant medication is discontinued during maintenance treatment (12, 13).”
Thase, M. E., McCrone, P., Barrett, M. S., Eells, T. D., Wisniewski, S. R., Balasubramani, G. K., Brown, G. K., & Wright, J. H. (2020) · Psychotherapy and Psychosomatics · doi:10.1159/000508143 · Cited by 60
Machmutow, K., Meister, R., Jansen, A., Kriston, L., Watzke, B., Härter, M. C., & Liebherz, S. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012855.pub2 · Cited by 67
“Vittengl 2007 Vittengl JR, Clark LA, Dunn TW, Jarrett RB. Reducing relapse and recurrence in unipolar depression: a comparative meta-analysis of cognitive-behavioral therapy's effects.”
BackgroundMethodResultInfluentialHärter, M. C., Klesse, C., Bermejo, I., Schneider, F. W., & Berger, T. (2010) · Deutsches Ärzteblatt international · doi:10.3238/arztebl.2010.0700 · Cited by 70
Two-year outcome of internet-based relapse prevention for partially remitted depression
Holländare, F., A. Anthony, S., Randestad, M., Tillfors, M., Carlbring, P., Andersson, G., & Engström, I. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.08.002 · Cited by 61
Sverre, K. T., Nissen, E. R., Farver-Vestergaard, I., Johannsen, M., & Zachariae, R. H. (2022) · Clinical Psychology Review · doi:10.1016/j.cpr.2022.102234 · Cited by 79
Jakobsen, J. C., Hansen, J. L., Simonsen, S., Simonsen, E., & Gluud, C. (2012) · Psychological Medicine · doi:10.1017/s0033291711002236 · Cited by 63
Ebert, D. D., Gollwitzer, M., Riper, H., Cuijpers, P., Baumeister, H., & Berking, M. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2511 · Cited by 61
“Despite strong evidence for the efficacy of psychotherapy for common mental health disorders [1,2], long-term outcome of psychotherapeutic interventions are still a major concern [3-6].”
A-Tjak, J. G. L., Morina, N., Topper, M., & Emmelkamp, P. M. G. (2018) · Psychotherapy and Psychosomatics · doi:10.1159/000486807 · Cited by 61
Metadata
- Authors
- Vittengl, J. R., Clark, L. A., Dunn, T. W., & Jarrett, R. B.
- Affiliations
- Truman State University (US)
- University of Iowa (US)
- The University of Texas Southwestern Medical Center (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2007
- Volume
- 75
- Issue
- 3
- Pages
- 475-488
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC2630051
- OpenAlex
- W1981386178
- Cited by
- 551
- References
- 102
- Citations by year
- 2026: 11 · 2025: 15 · 2024: 24 · 2023: 19 · 2022: 22 · 2021: 30 · 2020: 34 · 2019: 42 · 2018: 35 · 2017: 32 · 2016: 36 · 2015: 36 · 2014: 38 · 2013: 29 · 2012: 37
- FWCI
- 4.36
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH-58397; MH-01571)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- major depressive disorder, relapse prevention, recurrence prevention, cognitive behavioral therapy, acute phase treatment, psychotherapy versus pharmacotherapy, treatment discontinuation
- MeSH terms
- Depressive Disorder, Humans, Recurrence, Cognitive Behavioral Therapy
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