The effect of CBT and its modifications for relapse prevention in major depressive disorder: a systematic review and meta-analysis

Zhang, Zuojie; Zhang, Lingli; Zhang, Guorong; Jin, Jianing; Zheng, Zhenyang

doi:10.1186/s12888-018-1610-5

Table 1 Characteristics of included trials

From: The effect of CBT and its modifications for relapse prevention in major depressive disorder: a systematic review and meta-analysis

Study ID		Pre randomization /eligibility				Patients						Interventions
Author	Year	Condition	Previous episodes	Criteria used to measure relapse	Previous pharmacology interventions	N	Age^a	Male (N/%)	Previous episodes^a	% on ADM at baseline	Mean age of first onset^a	Groups (n/dropouts)	Form of intervention	N(Number of sessions, frequency, Mean duration + boost sessions)	Length of Follow-Up(months)
Bockting	2005	recurrent MDD, in remission for 10 weeks - 2 years	2 + recent episodes in the previous 5 years	SCID-I	NR	187	44.7/9.5	46/27	3.5/3.8	51	28.4/12.5	CBT:97/16	group	8,weekly,2 h	24
Bockting	2005	recurrent MDD, in remission for 10 weeks - 2 years	2 + recent episodes in the previous 5 years	SCID-I	NR	187	44.7/9.5	46/27	3.5/3.8	51	28.4/12.5	Control(TAU):90/6			24
Bondolfi	2010	recurrent MDD, in remission for 3 + months	3 + episodes (2 in the past 5 years and at least one in the past 2 years)	SCID	a history antidepressants treatment but off medication for 3 + months before enrolment.	60	47.5(24–66)	17/28	4(3–14)	30	24.5(8–55)	MBCT:31/4	group	8,weekly,2 h + 4 sessions each 3 months	14
Bondolfi	2010	recurrent MDD, in remission for 3 + months		SCID		60	47.5(24–66)	17/28	4(3–14)	30	24.5(8–55)	Control(TAU):29/1			14
Fava	1994	primary MDD, in full remission	NR	RDC-defined MDE	successfully response to antidepressant drugs according to a standardized protocol	40	43.7/2.3	16/40	NR	100	NR	CBT:20/0	individual	10,every other week,40 min	24
Fava	1994	primary MDD, in full remission	NR	RDC-defined MDE		40	43.7/2.3	16/40	NR	100	NR	Control(PLA):20/0			24
Fava	1998	MDD, in full remission for 10 week +	3 or 3 + episodes	RDC-defined MDE	successfully response to antidepressant drugs according to a standardized protocol.	40	46.1/3.7	13/32.5	3.6/0.8	100	NR	CBT:20/0	individual	10,every other week,30 min	24
Fava	1998	MDD, in full remission for 10 week +	3 or 3 + episodes	RDC-defined MDE		40	46.1/3.7	13/32.5	3.6/0.8	100	NR	Control(PLA):20/0			24
Godfrin	2010	MDD, in remission for 8 + weeks	3 or 3 + episodes	DSM-IV diagnosis of MDE	No special	106	45.7/10.5	20/19	NR	76.4	29.8/10.2	MBCT:52/18	group	8,weekly, 2.75 h + homework exercises (meditation practices) for 45 + min/d	14
Godfrin	2010	MDD, in remission for 8 + weeks	3 or 3 + episodes	DSM-IV diagnosis of MDE	No special	106	45.7/10.5	20/19	NR	76.4	29.8/10.2	Control(TAU):54/12			14
Hollandare	2013	MDD, in partial remission	1 + episodes in the previous 5 years	SCID	No special	84	45.3/12.8	13/15	5.96/9.1	50	NR	CBT:42/10	individual	16 internet modules + general e-mails for 10 weeks	24
Hollandare	2013	MDD, in partial remission	1 + episodes in the previous 5 years	SCID	No special	84	45.3/12.8	13/15	5.96/9.1	50	NR	Control(PLA)::42/7			24
Kuyken	2008	recurrent MDD, in full or partial remission	3 or 3 + episodes	SCID	on a continuing dose of m-ADM for 6 + months	123	49.2/11.2	29/24	6.4/3.0	100	26.2/12.1	MBCT-TS:61/9	group	8,weekly,2 h + 4 sessions	15
Kuyken	2008	recurrent MDD, in full or partial remission	3 or 3 + episodes	SCID	on a continuing dose of m-ADM for 6 + months	123	49.2/11.2	29/24	6.4/3.0	100	26.2/12.1	m-ADM:62/10			15
kuyken	2015	recurrent MDD, in full or partial remission	3 or 3 + episodes	SCID	on a continuing dose of m-ADM for 6 + months	424	49.5/12.5	99/23	46% 6 +	100	24.9/12.4	MBCT-TS:212/23	group	8,weekly, 2.25 h + 4 refresher sessions/3 months	24
kuyken	2015	recurrent MDD, in full or partial remission	3 or 3 + episodes	SCID	on a continuing dose of m-ADM for 6 + months	424	49.5/12.5	99/23	46% 6 +	100	24.9/12.4	m-ADM:212/18			24
Ma and Teasdale	2004	MDD, in remission for 12 + weeks	2 or 2 + episodes in the previous 5 years	modeled on the SCID	a history antidepressants treatment but off medication for 3 + months before enrolment.	75	44.5/9.0	18/24	3/2.0	100	30.6/12.4	MBCT:37/6	group	8,weekly, 2.75 h + homework exercises	13
Ma and Teasdale	2004	MDD, in remission for 12 + weeks	2 or 2 + episodes in the previous 5 years	modeled on the SCID		75	44.5/9.0	18/24	3/2.0	100	30.6/12.4	Control(TAU):38/1			13
Paykel	1999	MDD, in remission for 2–18 months	residual symptoms	DSM-III-R criteria for MDD for at least 1 month AND Minimum symptom score	all on a history antidepressants treatment	158	43.4/10.5	80/51	37% 3 +	100	NR	CBT:80/19	individual	16 sessions over 20 weeks + 2 sessions 6 and 14 weeks later	15.8
Paykel	1999	MDD, in remission for 2–18 months	residual symptoms		all on a history antidepressants treatment	158	43.4/10.5	80/51	37% 3 +	100	NR	Control(PLA):78/12			15.8
Segal	2010	MDD, in remission for 7+ months	3 + episodes	16 + on the HRSD-17 assessed twice then criteria for MDD measured with SCID	all on a history antidepressants treatment	54	44.1/11	31/37	4.7/2.3	55	31/11.6	MBCT:26/5	group	8,weekly,2 h + option 1 h/month mindfulness mediation class	18
Segal	2010	MDD, in remission for 7+ months	3 + episodes		all on a history antidepressants treatment	54	44.1/11	31/37	4.7/2.3	55	31/11.6	m-ADM:28/7			18
Stangier	2013	MDD, in full remission	3 or 3 + episodes	DSM-IV diagnosis of MDE (LIFE)	NR	180	48.6/11.6	50/27.8	7.4/8.3	74.8	30.9/12.4	Maintenance CBT: 90/15	individual	16,NR,50 min	12
Stangier	2013	MDD, in full remission	3 or 3 + episodes	DSM-IV diagnosis of MDE (LIFE)	NR	180	48.6/11.6	50/27.8	7.4/8.3	74.8	30.9/12.4	Manualized psychoeducation: 90/31	individual	16,NR,20 min	12
Teasdale	2000	MDD, in remission(0-24 months)	3 + episodes (2 in the past 5 years and at least one in the past 2 years)	SCID	a history antidepressants treatment but off medication for 3 + months before enrolment.	145	43.3/10.3	35/24	3.3/3.0	100	26.8/10.2	MBCT:76/13	group	8,weekly,2 h + 4 more sessions over trial duration	12
Teasdale	2000	MDD, in remission(0-24 months)		SCID		145	43.3/10.3	35/24	3.3/3.0	100	26.8/10.2	Control(TAU):69/0			12
Teismann	2014	MDD, in partial remission	NR	SCID	No special	60	47.1/11.8	17/28	22.45% 5 +	40	NR	CBT:31/2	group	11,weekly,90 min	12
Teismann	2014	MDD, in partial remission	NR	SCID	No special	60	47.1/11.8	17/28	22.45% 5 +	40	NR	WL:29/5			12
Wilkinson	2009	MDD, in remission for 2 + months	NR	MADRS score of 10 + at 6/12 months	Received antidepressant medication	45	74.0/7.3	17/38	3.0/1.9	100	NR	CBT:22/4	group	8,NR,90 min	12
Wilkinson	2009	MDD, in remission for 2 + months	NR	MADRS score of 10 + at 6/12 months	Received antidepressant medication	45	74.0/7.3	17/38	3.0/1.9	100	NR	Control(PLA):23/5			12
Williams	2014	MDD, in remission for 8+ weeks	3 or 3 + episodes	SCID	NR	164	43.4/12	76/28	77% 5 +	44	21.3/10.7	MBCT:108/9	group	individual pre class interview + 8,weekly,2 h + follow-up classes taking place 6 weeks and 6 months in the follow-up	12
Williams	2014	MDD, in remission for 8+ weeks	3 or 3 + episodes	SCID	NR	164	43.4/12	76/28	77% 5 +	44	21.3/10.7	Control(TAU):56/3			12

Note:
^a Mean/SD, Median(range)
CBT cognitive behavioral therapy, CPE cognitive psychological education, MBCT mindfulness-based cognitive therapy, MBCT-TS MBCT with support to taper or discontinue antidepressant treatment, TAU treatment as usual, m-ADM Maintenance antidepressant medication, WL wait-list, PLA (psychological or pill) placebo
Criteria used to measure relapse:
DSM Diagnostic Statistical Manual, LIFE Longitudinal Interval Follow-up Evaluation, MDD MDD Disorder, MDE MDD Episode, RDC Research Diagnostic Criteria, SCID Structured Clinical Interview for DSM Disorders, MADRS Montgomery–Asberg Depression Rating Scale, HRSD Hampton Roads Sanitation District

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