Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal study
IntroductionMajor 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 treatme...
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Frontiers Media S.A.
2025-06-01
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| author | Jón Ingi Hlynsson Jón Ingi Hlynsson Tómas Kristjánsson Gerhard Andersson Gerhard Andersson Gerhard Andersson Per Carlbring Per Carlbring the ACTUA research group |
| author_facet | Jón Ingi Hlynsson Jón Ingi Hlynsson Tómas Kristjánsson Gerhard Andersson Gerhard Andersson Gerhard Andersson Per Carlbring Per Carlbring the ACTUA research group |
| author_sort | Jón Ingi Hlynsson |
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| description | IntroductionMajor 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. However, evidence for the effectiveness of these treatment booster sessions remains inconclusive. This study therefore evaluated the long-term effectiveness of relapse prevention treatment booster sessions for major depression.MethodIn a two-arm, parallel-group, maintenance-phase randomized controlled trial (RCT) with repeated longitudinal measures, 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 quarterly diagnostic interviews (Mini-International Neuropsychiatric Interview; MINI).ResultsBoth 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. Furthermore, all pre-hypothesized predictors of relapse were non-significant in differentiating the two groups at 24-month follow-up.DiscussionThese 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.Clinical trail registrationClinicalTrials.gov, identifier NCT01619930. |
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| institution | Kabale University |
| issn | 1664-1078 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Psychology |
| spelling | doaj-art-48446df318a94ccaa7d3daea9c38b56c2025-08-20T03:32:07ZengFrontiers Media S.A.Frontiers in Psychology1664-10782025-06-011610.3389/fpsyg.2025.15681411568141Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal studyJón Ingi Hlynsson0Jón Ingi Hlynsson1Tómas Kristjánsson2Gerhard Andersson3Gerhard Andersson4Gerhard Andersson5Per Carlbring6Per Carlbring7the ACTUA research groupDepartment of Psychology, University of Iceland, Reykjavík, IcelandDepartment of Psychology, Stockholm University, Stockholm, SwedenDepartment of Psychology, University of Iceland, Reykjavík, IcelandDepartment of Behavioural Sciences and Learning, Linköping University, Linköping, SwedenDepartment of Biomedical and Clinical Sciences, Linköping University, Linköping, SwedenDepartment of Clinical Neuroscience, Karolinska Institute, Stockholm, SwedenDepartment of Psychology, Stockholm University, Stockholm, SwedenSchool of Psychology, Korea University, Seoul, Republic of KoreaIntroductionMajor 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. However, evidence for the effectiveness of these treatment booster sessions remains inconclusive. This study therefore evaluated the long-term effectiveness of relapse prevention treatment booster sessions for major depression.MethodIn a two-arm, parallel-group, maintenance-phase randomized controlled trial (RCT) with repeated longitudinal measures, 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 quarterly diagnostic interviews (Mini-International Neuropsychiatric Interview; MINI).ResultsBoth 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. Furthermore, all pre-hypothesized predictors of relapse were non-significant in differentiating the two groups at 24-month follow-up.DiscussionThese 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.Clinical trail registrationClinicalTrials.gov, identifier NCT01619930.https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1568141/fullmajor depressionbehavioral activationphysical activityrelapse preventiontreatment boostersurvival analysis |
| spellingShingle | Jón Ingi Hlynsson Jón Ingi Hlynsson Tómas Kristjánsson Gerhard Andersson Gerhard Andersson Gerhard Andersson Per Carlbring Per Carlbring the ACTUA research group Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal study Frontiers in Psychology major depression behavioral activation physical activity relapse prevention treatment booster survival analysis |
| title | Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal study |
| title_full | Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal study |
| title_fullStr | Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal study |
| title_full_unstemmed | Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal study |
| title_short | Evaluating the necessity of booster sessions in relapse prevention for depression: a longitudinal study |
| title_sort | evaluating the necessity of booster sessions in relapse prevention for depression a longitudinal study |
| topic | major depression behavioral activation physical activity relapse prevention treatment booster survival analysis |
| url | https://www.frontiersin.org/articles/10.3389/fpsyg.2025.1568141/full |
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