Randomized trial of Internet-based relapse prevention for partially remitted depression

Holländare F, Johnsson S, Randestad M, Tillfors M, Carlbring P, Andersson G, Engström I. Randomized trial of Internet‐based relapse prevention for partially remitted depression. Objective: To investigate whether Internet‐based cognitive behaviour therapy (CBT) can prevent relapse in persons with partially remitted major depression after previous treatment. Method: Seventy‐one women and 13 men (N = 84) with partially remitted major depression after treatment were randomly assigned to either 10 weeks of Internet‐based CBT or to a control group. Self‐help material was used in combination with e‐mail contact with a personal therapist. Monthly self‐ratings of depressive symptoms were made, and diagnostic interviews were conducted before and after the treatment period, as well as 6 months later. Results: Significantly fewer participants in the CBT group experienced relapse (4/38 or 10.5%) compared with those in the control group (14/37 or 37.8%). The difference in relapse rates between groups occurred early in the study period and was still apparent after 6 months. A trend towards a larger reduction in depressive symptoms was observed at post‐treatment in the participants who received CBT compared with controls. Reduction in depressive symptoms reduced the risk of relapse. A trend towards a higher remission rate was found in the CBT group at the 6 month follow‐up. Conclusion: Internet‐based CBT seems promising in preventing relapse in persons with partially remitted major depression after previous treatment.