Psychological theories of depressive relapse and recurrence: A systematic review and meta-analysis of prospective studies

Marlies E. Brouwer, Alishia D. Williams, Mitzy Kennis, Zhongfang Fu, Nicola S. Klein, Pim Cuijpers, Claudi L.H. Bockting*

*Corresponding author for this work

Research output: Contribution to JournalReview articleAcademicpeer-review

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Abstract

Psychological factors hypothesized to account for relapse of major depressive disorder (MDD) roughly originate from five main theories: Cognitive, diathesis-stress, behavioural, psychodynamic, and personality-based. In a meta-analysis we investigated prospective, longitudinal evidence for these leading psychological theories and their factors in relation to depressive relapse. Included studies needed to establish history of MDD and prospective depressive relapse through a clinical interview, have a longitudinal and prospective design, and measure at least one theory-derived factor before relapse. We identified 66 eligible articles out of 43,586 records published up to November 2018. Pooled odds ratios (OR) indicated a significant relationship between the cognitive, behavioural, and personality-based theories and depressive relapse (cognitive: k = 17, OR = 1.24, 95% CI = 1.10–1.40; behavioural, k = 8, OR = 1.15, 95% CI = 1.05–1.25; personality: k = 12, OR = 1.26, 95% CI = 1.02–1.54), but not for the psychodynamic theories (k = 4, OR = 1.29, 95% CI = 0.83–1.99). Pooled hazard ratios of the theories were not significant. There were no articles identified for the diathesis-stress theories. To conclude, there is a restricted number of prospective studies, and some evidence that the cognitive, behavioural, and personality-based theories indeed partially account for depressive relapse.

Original languageEnglish
Article number101773
Pages (from-to)1-16
Number of pages16
JournalClinical Psychology Review
Volume74
Early online date13 Nov 2019
DOIs
Publication statusPublished - Dec 2019

Keywords

  • Major depressive disorder
  • Psychological theories
  • Recurrence
  • Relapse
  • Review
  • Vulnerability factors

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