Treatment Maintenance for Unipolar Depression: Relevant Issues, Literature Review, and Recommendations for Research and Clinical Practice

This article reviews the extant literature involving maintenance of treatment effects for depression and provides specific recommendations for future research directions and current clinical practice. Regarding research directions, we emphasize the following strategies: use consistent operational definitions, use consistent measurement criteria, provide complete descriptions of subject samples, test specific treatment components, use dismantling and constructive treatment outcome strategies, use parametric research approaches, use primary and secondary prevention approaches, view depression from a public health perspective, measure maintenance effects often, conduct matching studies, conduct more prediction investigations, and broaden population samples. Clinically, we recommend the following three guidelines: apply a problem-solving model of case formulation, take predictors of relapse into account when designing individual treatment plans, and, in general, conceptualize depression as a recurrent disorder.