An evaluation of the 'Coping with Depression Course' for relapse prevention with unipolar depressed patients

Patients with treated episodes of depression are at high risk of relapse and recurrence. This study describes the clinical course of patients who had received cognitive-behavioral group intervention for relapse prevention.

Forty-four remitted unipolar depressed patients with recently treated episodes of illness participated in a 16-week group program, the 'Coping with Depression Course' (CWD). The majority of patients had suffered from multiple episodes of depression and nearly half of them were only partially remitted when they started the program. Assessments took place throughout the intervention and 17-23 months after the pretest. Descriptive analyses included proportions of reliable and clinically significant improvements, and cumulative relapse rates were estimated using survival analysis.

At posttest, residual depression and dysfunctional attitudes had significantly decreased. Improvements were similar in patients with and those without parallel antidepressant medication. Two thirds of patients starting within a dysfunctional depression range showed a clinically significant improvement at the end of the intervention. The estimated cumulative relapse rates at 6, 12, 17, and 23 months after pretest were 13.6, 30.0, 37.0 and 44.9%.

Participants appeared to be protected from relapse during active intervention, but a substantial proportion suffered relapses in the postintervention period. Further research into the CWD is needed within the framework of randomized controlled trials.