An Individual Participant Data meta-analysis of psychological interventions for preventing depressive relapse

Abstract

Major depressive disorder (MDD) is a leading cause of disability worldwide, identifying effective strategies to prevent depressive relapse is crucial. This individual patient data meta-analysis (IPDMA) addresses whether and for whom psychological interventions can be recommended for relapse prevention of MDD. One and two-stage IPDMA on 14 randomised controlled trials (N = 1720) were conducted. The relapse risk over 12 months was substantially lower for those who received a psychological intervention versus treatment as usual (TAU), antidepressant or evaluation only control (Hazard Ratio (HR): 0.60 (95% CI 0.48 – 0.74). The number of previous depressive episodes moderated the treatment effect, with psychological interventions demonstrating greater efficacy for patients with three or more prior episodes. Our results suggest that adding psychological interventions to current treatment in order to prevent depressive relapse is recommended. For patients at lower risk of relapse, less intensive approaches may be indicated.