Interventions for preventing relapse or recurrence of depression in primary health care settings: A systematic review

Abstract

Objective: A systematic review was conducted to assess the efficacy of pharmacological and psychological interventions for preventing relapse or recurrence of depression in adults with depression in primary care.

Method: Papers published from inception to January 28th 2014 were identified searching the electronic databases MEDLINE, EMBASE, PsycINFO, and CENTRAL. Randomized controlled trials of any pharmacological, psychological or psychosocial intervention or combination of interventions delivered in primary care settings were included, with relapse or recurrence of a depressive disorder as a main outcome. The Cochrane Collaboration risk of bias tool was used to assess study quality.

Results: Only three studies with a small number of patients fulfilled the inclusion criteria. None of the three randomized controlled trials included in our review showed a statistically significant superiority of an intervention for the prevention of depression relapse or recurrence.

Conclusions: There is limited evidence to inform relapse or recurrence prevention strategies specifically in primary care.

Keywords: Depression; Primary health care; Recurrence; Relapse; Secondary prevention.