OBJECTIVE: The authors' goal was to determine whether cognitive
behavioral treatment of residual symptoms of depression might have a
significant effect on relapse rate. METHOD: In an earlier study, 40
patients with primary major depressive disorder who had been successfully
treated with antidepressant drugs were randomly assigned to either
cognitive behavioral treatment of residual symptoms or standard clinical
management. In both types of treatment, antidepressant drugs were gradually
tapered and discontinued. In this study, a 4-year follow-up assessment was
performed. RESULTS: Cognitive behavioral treatment resulted in a
substantially lower relapse rate (35%) than did clinical management (70%).
CONCLUSIONS: Cognitive behavioral treatment of residual symptoms reduces
the risk of relapse in depressed patients, probably by affecting the
progression of residual symptoms to prodromes of relapse.