Evaluating the Necessity of Booster Sessions in Relapse Prevention for Depression: A Longitudinal Study

Jón Ingi Hlynsson^1,2Tómas Kristjánsson¹Gerhard Andersson^3,4,5Per Carlbring^2,6*

• ¹Department of Psychology, University of Iceland, Reykjavík, Iceland, Reykjavík, Iceland
• ²Stockholm University, Stockholm, Sweden
• ³Department of Behavioural Sciences and Learning, Linköping University, Linköping, Östergötland, Sweden
• ⁴Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden, Linköping, Sweden
• ⁵Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden, Solna, Sweden
• ⁶School of Psychology, Korea University, Seoul, South Korea, Seoul, Luxembourg

Major depression is a highly prevalent and heterogenous mental disorder. Although therapeutic advances for major depressive disorder over the past quarter-century have been incremental rather than transformative, booster sessions have been proposed as a means of solidifying acute treatment gains and lowering relapse risk.Despite its impact, no significant advances in depression treatment have been made in the past 25 years. Treatment boosters have shown some promise in solidifying treatment gains and been proposed to decrease the risk of relapse; howeverHowever, evidence for the effectiveness of these treatment booster sessions remains inconclusive., evidence for their efficacy is still inconclusive. TThis his study therefore evaluated the long-term effectiveness of relapse prevention treatment booster sessions for major depression. Method: In a two-arm, parallel-group, maintenance-phase randomized controlled trial (RCT) with repeated longitudinal measures, The the sample consisted of participants in Sweden who had received acute treatment for depression (internet-based behavioral activation or physical activity) and were then randomly assigned to either an 8-week relapse prevention program (n=119) or control group (n=143). Participants were followed-up for 24-months with both monthly self-report questionnaires (Patient Health Questionnaire 9-item & Generalized Anxiety Disorder 7-item) and and quarterly diagnostic interviews (Mini-International Neuropsychiatric Interview; MINI). Results: Both the relapse prevention group and control group exhibited similar depression-free trends over the course of the study period, with over 95% of participants in each group maintaining remission at the 24-month follow-up. MoreoverFurthermore, all pre-hypothesized predictors of relapse were principally non-significant in differentiating the two groups at 24-month follow-up. Discussion: These findings raise the question of whether treatment booster sessions are uniformly advisable for all mild-moderate cases of depression. For instance, preferentially recommending treatment boosters for psychotherapy-naïve individuals with depression may yield greater effects compared to individuals with difficult-to-treat depression. Our findings indicate that the efficacy of behavioral activation and physical activity may be even greater than previously reported, a testament to the lasting effects of internet-based psychotherapy. 1 Ändrad fältkod formaterade: Engelska (USA) Ändrad fältkod formaterade: Engelska (USA) formaterade: Engelska (USA)