{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T05:47:39Z","timestamp":1792907259996,"version":"4.5.0"},"reference-count":71,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T00:00:00Z","timestamp":1553126400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behav. Cogn. Psychother."],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S1352465819000080_as1\"><jats:title>Background:<\/jats:title><jats:p>Cognitive behavioural therapy (CBT) is an effective psychological treatment for major depressive disorder, although some patients experience a return of symptoms after finishing therapy. The ability to predict which individuals are more vulnerable to deterioration would allow for targeted interventions to prevent short-term relapse and longer-term recurrence.<\/jats:p><\/jats:sec><jats:sec id=\"S1352465819000080_as2\"><jats:title>Aim:<\/jats:title><jats:p>This systematic review and meta-analysis aimed to identify factors associated with an increased risk of relapse and\/or recurrence (RR) after CBT for depression.<\/jats:p><\/jats:sec><jats:sec id=\"S1352465819000080_as3\"><jats:title>Method:<\/jats:title><jats:p>We reviewed 13 relevant papers, of which a small set of unique samples were eligible for meta-analysis (<jats:italic>k<\/jats:italic>= 5,<jats:italic>N<\/jats:italic>= 369). Twenty-six predictor variables were identified and grouped into seven categories: residual depressive symptoms; prior episodes of depression; cognitive reactivity; stressful life events; personality factors; clinical and diagnostic factors; demographics.<\/jats:p><\/jats:sec><jats:sec id=\"S1352465819000080_as4\"><jats:title>Results:<\/jats:title><jats:p>Meta-analyses indicated that residual depressive symptoms (<jats:italic>r<\/jats:italic>= 0.34 [0.10, 0.54],<jats:italic>p<\/jats:italic>= .01) and prior episodes (<jats:italic>r<\/jats:italic>= 0.19 [0.07, 0.30],<jats:italic>p<\/jats:italic>= .002) were statistically significant predictors of RR, but cognitive reactivity was not (<jats:italic>r<\/jats:italic>= 0.18 [\u22120.02, 0.36],<jats:italic>p<\/jats:italic>= .08). Other variables lacked replicated findings. On average, 33.4% of patients experienced RR after CBT.<\/jats:p><\/jats:sec><jats:sec id=\"S1352465819000080_as5\"><jats:title>Conclusions:<\/jats:title><jats:p>Patients with the above risk factors could be offered evidence-based continuation-phase interventions to enhance the longer-term effectiveness of CBT.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s1352465819000080","type":"journal-article","created":{"date-parts":[[2019,3,21]],"date-time":"2019-03-21T08:05:58Z","timestamp":1553155558000},"page":"514-529","source":"Crossref","is-referenced-by-count":101,"title":["Predictors of depression relapse and recurrence after cognitive behavioural therapy: a systematic review and meta-analysis"],"prefix":"10.1017","volume":"47","author":[{"given":"Caroline","family":"Wojnarowski","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nick","family":"Firth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Finegan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaime","family":"Delgadillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,3,21]]},"reference":[{"key":"S1352465819000080_ref32","doi-asserted-by":"publisher","DOI":"10.1002\/da.22177"},{"key":"S1352465819000080_ref31","doi-asserted-by":"publisher","DOI":"10.1037\/a0027665"},{"key":"S1352465819000080_ref33","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"S1352465819000080_ref25","doi-asserted-by":"publisher","DOI":"10.1037\/a0032985"},{"key":"S1352465819000080_ref22","doi-asserted-by":"publisher","DOI":"10.1037\/a0034933"},{"key":"S1352465819000080_ref37","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.62.4.417"},{"key":"S1352465819000080_ref21","first-page":"307","volume-title":"Cognitive and Behavioral Theories in Clinical Practice","author":"Dimidjian","year":"2010"},{"key":"S1352465819000080_ref20","doi-asserted-by":"publisher","DOI":"10.1159\/000485386"},{"key":"S1352465819000080_ref17","volume-title":"Analysis of Survival Data","volume":"21","author":"Cox","year":"1984"},{"key":"S1352465819000080_ref26","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.75.3.447"},{"key":"S1352465819000080_ref16","doi-asserted-by":"publisher","DOI":"10.1037\/0033-2909.112.1.155"},{"key":"S1352465819000080_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajp.2008.09.006"},{"key":"S1352465819000080_ref36","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.157.11.1873"},{"key":"S1352465819000080_ref13","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2007.02.005"},{"key":"S1352465819000080_ref11","doi-asserted-by":"publisher","DOI":"10.1002\/9780470743386"},{"key":"S1352465819000080_ref7","doi-asserted-by":"publisher","DOI":"10.1037\/h0037562"},{"key":"S1352465819000080_ref5","doi-asserted-by":"publisher","DOI":"10.1037\/0022-006X.56.6.893"},{"key":"S1352465819000080_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/S0005-7894(97)80043-3"},{"key":"S1352465819000080_ref1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1997.tb09641.x"},{"key":"S1352465819000080_ref38","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1983.03340240025024"},{"key":"S1352465819000080_ref9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7610.1994.tb01284.x"},{"key":"S1352465819000080_ref39","doi-asserted-by":"publisher","DOI":"10.1046\/j.1600-0447.2003.00266.x"},{"key":"S1352465819000080_ref23","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1992.01820100046009"},{"key":"S1352465819000080_ref34","volume-title":"Cochrane Handbook for Systematic Reviews of Interventions","volume":"4","author":"Higgins","year":"2011"},{"key":"S1352465819000080_ref27","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1991.01810330075011"},{"key":"S1352465819000080_ref24","volume-title":"Eysenck Personality Inventory Manual","author":"Eysenck","year":"1968"},{"key":"S1352465819000080_ref67","unstructured":"U.S. Department of Health and Human Services (2014). 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