Study Identifies Vulnerability to Depression Relapse

A recent CAMH study showed that individuals who recover from depression may continue to be at risk for relapse, if brief feelings of sadness trigger depressive thinking styles.  This is the first study to make the link between these differences in thinking styles and the prediction of illness relapse, following successful treatment for depression. The study results suggest that treatment approaches directly targeting thinking styles may be an effective tool in preventing depression relapse.

Lead by CAMH scientist Dr. Zindel Segal, the new study revealed that individuals who achieved clinical remission from depression through antidepressant medication showed greater levels of depressive thinking after a procedure that caused temporary sadness, compared to those who had received cognitive behaviour therapy.  Regardless of the type of treatment, the magnitude of depressive thinking revealed while patients were briefly sad was a significant predictor of relapse. 

The data showed that 51% of participants had a relapse of depression during the follow up phase of the study. Classifying patients on the basis of the how significant a change in depressive thinking they showed, following an experimental induction of sadness, allowed for 81% of relapsers to be correctly identified. These results demonstrate a residual but increased risk for relapse that has not been fully addressed by treatment.

Major depression is now the leading cause of disability globally, and more than 50% of people diagnosed with clinical depression will experience a relapse in symptoms.  Yet, routine clinical management of depression targets reducing symptoms during the acute phase of the illness.  Little attention is paid to strategies for reducing the risk of relapse, or to measures that are able to identify those people in remission who are at risk for a relapse of depression.

This work holds promise for the design of more effective treatments that, in addressing this vulnerability, will allow people to get well and stay well longer. Dr. Segal is already studying the effects of a novel treatment that teaches patients how to address these mood-linked changes in thinking styles through the practice of mindfulness meditation. 

Visit http://archpsyc.ama-assn.org for a full copy of Dr. Segal’s paper entitled “Cognitive Reactivity to Sad Mood Provocation and the Prediction of Depressive Relapse.”

Click here to view CAMH’s press release on this study.

 

 

 

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