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Psychological interventions
Preventive cognitive therapy could be a viable and effective addition to antidepressant medication in preventing relapse or recurrence in major depressive disorder
  1. Marloes J Huijbers,
  2. Carolien Wentink,
  3. Anne E M Speckens
  1. Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
  1. Correspondence to Dr Marloes J Huijbers, Departmentof Psychiatry, Radboud University Medical Center, Nijmegen 6525 GC, The Netherlands; marloes.huijbers{at}

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Commentary on: Bockting CLH, Klein NS, Elgersma HJ, et al. Effectiveness of preventive cognitive therapy while tapering antidepressants versus maintenance antidepressant treatment versus their combination in prevention of depressive relapse or recurrence (DRD study): a three-group, multicentre, randomised controlled trial. Lancet Psychiatry. 2018; 5:401-410.

What is already known on this topic

Many patients with major depressive disorder (MDD) are treated with maintenance antidepressant medication (mADM) to prevent relapse and recurrence. There is increasing evidence that psychological interventions may be at least as effective in terms of relapse prevention in recurrent MDD.1 However, discontinuing mADM has been demonstrated as potentially difficult and associated with increased relapse risk.2

Methods of the study

The current study3 was a three-group, multicentre, single-blind, parallel, randomised controlled trial(supplementary file 1). Patients with recurrent MDD in remission (n=289) were recruited in the Netherlands between 2009 and 2015, via general practitioners (GP), pharmacists, specialised mental healthcare centres and the media, and randomly allocated (10:10:8) to receive either preventive cognitive therapy (PCT) plus mADM (n=104), mADM alone (n=100) or PCT with tapering of mADM (n=85).

Supplementary file 1


PCT consisted of …

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  • Patient consent for publication Not required.

  • Contributors The commentary was drafted by MH and edited by CW and AEMS. All authors read and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests MH is employed by the Radboud University Medical Center, Center for Mindfulness, as a researcher and mindfulness teacher. AEMS is director of the Radboud University Medical Center, Center for Mindfulness, and received a grant in 2015 from the Dutch Health Care Insurers Innovation Foundation (No 3.048) for a cluster randomised controlled trial of Discontinuation of Antidepressant Medication in Primary Care Supported by Monitoring Plus Mindfulness-based Cognitive Therapy Versus Monitoring Alone. This work is carried out by CW.

  • Provenance and peer review Commissioned; internally peer reviewed.

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