Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis

Bruin, Esther Krijnen-de; Scholten, Willemijn; Muntingh, Anna; Maarsingh, Otto R; Meijel, Berno van; Straten, Annemieke van; Batelaan, Neeltje M.

doi:10.1371/journal.pone.0272200

Cited by 8 publications

(4 citation statements)

References 95 publications

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“…Longer follow-up times may thus be a more representative exposure to estimate efficacy of relapse prevention 49. Contrary to our findings, such preventive effects of psychotherapy have repeatedly been found among patients with remitted MDD 9…”

Section: Resultscontrasting

confidence: 91%

“… 49 Contrary to our findings, such preventive effects of psychotherapy have repeatedly been found among patients with remitted MDD. 9 …”

Section: Resultsmentioning

confidence: 99%

“…Unfortunately, approximately one-third of patients treated with pharmacotherapy and/or psychotherapy continue to experience considerable symptoms and only reach partial remission of MDD 3–7. Surprisingly, while a myriad of reviews and randomised clinical trials (RCTs) have examined treatment effects for acute MDD or relapse prevention,8–10 partial remission has been a neglected research area. Therefore, an overview of the evidence for treatment targeting partial remission is highly needed.…”

Section: Introductionmentioning

confidence: 99%

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Treatments for partial remission of major depressive disorder: a systematic review and meta-analysis

Gülpen,

Brouwer,

Geurtsen

et al. 2023

BMJ Ment Health

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QuestionPartial remission of major depressive disorder (MDD) is a debilitating and distressing clinical state related to chronicity, morbidity and relapse. Although one-third of patients remit partially, evidence for treatment efficacy is unclear. We provide an overview of treatment options and their efficacy.Study selection and analysisEmbase, PsycINFO, Medline and SCOPUS were systematically searched through February 2023. Included were randomised controlled trials (RCTs) examining any treatment in patients with partially remitted MDD aged 13–65 years, reporting data on severity, remission or relapse.FindingsSeven RCTs examining psychotherapy including 1024 patients were eligible. There were not enough RCTs to examine effects of pharmacotherapy. Psychotherapy was associated with lower depressive symptom severity at post-treatment (Hedges’ g=0.50; 95% CI 0.23 to 0.76), but not at follow-up up to 1 year (Hedges’ g=0.36; 95% CI −0.30 to 1.02) or longer (Hedges’ g=0.02; 95% CI −0.09 to 0.12). Psychotherapy was associated with superior remission rates at post-treatment (OR 2.57; 95% CI 1.71 to 3.87) and follow-up 6 months or longer (OR 1.75; 95% CI 1.21 to 2.53), although not with improved relapse rates at post-treatment (OR 0.17; 95% CI 0.01 to 4.83) or follow-up 6 months or longer (OR 0.46; 95% CI 0.21 to 1.03). Overall methodological quality was poor.ConclusionsPsychotherapy targeting partial remission may be effective in lowering depressive symptom severity and patients may potentially achieve full remission twice as likely. Yet, long-term and prophylactic effects are lacking. Given the risk of chronicity, more high-quality RCTs are needed.PROSPERO registration numberCRD42020188451.

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Section: Resultscontrasting

confidence: 91%

“… 49 Contrary to our findings, such preventive effects of psychotherapy have repeatedly been found among patients with remitted MDD. 9 …”

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Treatments for partial remission of major depressive disorder: a systematic review and meta-analysis

Gülpen,

Brouwer,

Geurtsen

et al. 2023

BMJ Ment Health

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“…This will provide a more comprehensive picture of the relationship between the patient's condition and the level of anxiety and depression of family members. 5…”

mentioning

confidence: 99%

Anxiety and Depression in Family Members of Critically III Covid-19 Inpatients: Brief Psychological Interventions via Telephone, an Exploratory Study [Letter]

Syaekhu

2023

JMDH

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We have read the paper by Nancy Patricia et al about Anxiety and Depression in Family members of Critically III Covid-19 Inpatients: Brief Psychological Interventions via Telephone, an Exploratory Study. 1 We congratulate all authors for providing initial evidence that brief psychological interventions via telephone are effective in reducing levels of anxiety and depression in family members of critical COVID-19 patients, because psychological stress often leads to burnout. Maintaining psychological health is very important to prevent the emergence of mental disorders in at-risk populations. 2,3 The study conducted by Nancy Patricia et al aimed to assess levels of anxiety and depression and explore the effectiveness of brief psychological interventions delivered by telephone. 1 However, this research was only conducted on family members of critical COVID-19 patients who were treated in the intensive care unit, so the sample is limited to that population. This can affect the representativeness of research results. We recommend that there be a control group that does not receive any intervention at all to determine the extent of the effect of psychological interventions in reducing anxiety and depression. 4 The study conducted by Nancy Patricia et al used an exploratory method with a pilot study design through a brief psychological intervention given by telephone to family members of critical COVID-19 patients followed by anxiety assessment using GAD-7. 1 The method used is effective in measuring the final objective of this research. However, we would like to recommend one instrument that can be used together with the GAD-7 to assess anxiety levels, namely using psychological intervention with MBSR (Mindfulness-Based Stress Reduction) and other mindfulness training programs. Both online and face to face to support health professionals in increasing and reducing respondents' anxiety levels. 2 In conclusion, we agree that brief psychological interventions delivered by telephone are effective in reducing levels of anxiety and depression in family members of critical COVID-19 patients, 1 however we recommend conducting longterm follow-up to see the effect of the intervention over a longer period of time. This will help evaluate the sustainability of the intervention's effects and its impact on the well-being of family members in the long term. 3 In addition, researchers can also use objective measurements of the patient's clinical condition, such as disease severity scores or biomedical parameters, to complement subjective data collected from family members. This will provide a more comprehensive picture of the relationship between the patient's condition and the level of anxiety and depression of family members. 5

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Unpredictable chronic mild stress induced anxio-depressive disorders and enterobacteria dysbiosis: Potential protective effects of Detarium microcarpum

Tchinda Defo,

Moussa,

Bouvourné

et al. 2025

Journal of Ethnopharmacology

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Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis

Cited by 8 publications

References 95 publications

Treatments for partial remission of major depressive disorder: a systematic review and meta-analysis

Treatments for partial remission of major depressive disorder: a systematic review and meta-analysis

Anxiety and Depression in Family Members of Critically III Covid-19 Inpatients: Brief Psychological Interventions via Telephone, an Exploratory Study [Letter]

Unpredictable chronic mild stress induced anxio-depressive disorders and enterobacteria dysbiosis: Potential protective effects of Detarium microcarpum

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