Background:Findings of substantial remaining morbidity in treated major depressive disorder (MDD) led us to review controlled trials of treatments aimed at preventing early relapses or later recurrences in adults diagnosed with MDD to summarize available data and to guide further research.Methods:Reports (n = 97) were identified through systematic, computerized literature searching up to February 2015. Treatment versus control outcomes were summarized by random-effects meta-analyses.Results:In 45 reports of 72 trials (n = 14 450 subjects) lasting 33.4 weeks, antidepressants were more effective than placebos in preventing relapses (response rates [RR] = 1.90, confidence interval [CI]: 1.73–2.08; NNT = 4.4; p < 0.0001). In 35 reports of 37 trials (n = 7253) lasting 27.0 months, antidepressants were effective in preventing recurrences (RR = 2.03, CI 1.80–2.28; NNT = 3.8; p < 0.0001), with minor differences among drug types. In 17 reports of 22 trials (n = 1 969) lasting 23.7 months, psychosocial interventions yielded inconsistent or inconclusive results.Conclusions:Despite evidence of the efficacy of drug treatment compared to placebos or other controls, the findings further underscore the substantial, unresolved morbidity in treated MDD patients and strongly encourage further evaluations of specific, improved individual and combination therapies (pharmacological and psychological) conducted over longer times, as well as identifying clinical predictors of positive or unfavorable responses and of intolerability of long-term treatments in MDD.

Adinandra belukar is a species-poor forest dominated by Adinandra dumosa (Theaceae) found in Singapore and southern Peninsular Malaysia. It is the product of secondary succession after exhaustive agricultural exploitation on land cleared of primary lowland rain forest. A high degree of similarity in vegetation between different sites was found for seven 225 m 2 plots in adinandra belukar in Singapore.Adinandra dumosa was dominant or codominant in all plots, generally found in association with the woody species Dillenia suffruticosa, Fagraea fragrans, and Rhodamnia cinerea, the climber Gynochthodes sublanceolata, the fern Dicranopteris Iinearis and the terrestrial orchid Bromheadia finlaysoniana. All sites had extremely acidic (pH 3.3-3.9) surface (0-20 cm) mineral soils with very low total nitrogen (0.06-0.14~o) and total phosphorus (11-29 #g g -l ) contents and very high carbon/nitrogen ratios (33-48). Adinandra belukar is interpreted as a heath forest because of its floristic and physiognomic similarities with this forest formation.Nomenclature: follows Turner, Chua and Tan (1990), A checklist of the native and naturalized vascular plants of the Republic of Singapore.