Objectives: To revise theories and the available evidence about Cognitive Behavioral Therapy (CBT) role on the relapse and recurrence prevention of depressive episodes.
Methods: Review of random and controlled clinical trials that investigated CBT efficacy on the relapse and recurrence prevention of depressive episodes. The following databases were used: Medline, Lilacs, Cochrane, Biosis and Embase. The reference sections of the selected articles, review articles and specialized books were consulted.
Results: Fifteen studies with different experimental design were found, several with methodological problems. The majority of them compared CBT with antidepressants at the acute treatment phase. In 12 studies CBT significantly lowered the relapse/recurrence rate. Recent papers pointed to the CBT usefulness for treating residual depressive symptoms as a recurrence prevention strategy.
Conclusion: CBT was effective for the depression relapse reduction. Its relationship with antidepressants as a prevention tool and CBT strategies (using it only in the acute phase, or during acute and maintenance phases, or after antidepressants withdrawal as a maintenance treatment, or focusing residual symptoms) need to be better investigated.