Meta-Analysis: Relapse Prevention Strategies for Depression and Anxiety in Remitted Adolescents and Young Adults.

by Robberegt, Suzanne J., Brouwer, Marlies E., Kooiman, Bas E. A. M., Stikkelbroek, Yvonne A. J., Nauta, Maaike H. and Bockting, Claudi L. H.
Abstract:
OBJECTIVE: Depression and anxiety cause a high burden of disease and have high relapse rates (39%-72%). This meta-analysis systematically examined effectiveness of relapse prevention strategies on risk of and time to relapse in youth who remitted. METHOD: PubMed, PsycInfo, Embase, Cochrane, and ERIC databases were searched up to June 15, 2021. Eligible studies compared relapse prevention strategies to control conditions among youth (mean age 13-25 years) who were previously depressed or anxious or with ≥30% improvement in symptoms. Two reviewers independently assessed titles, abstracts, and full texts; extracted study data; and assessed risk of bias and overall strength of evidence. Random-effects models were used to pool results, and mixed-effects models were used for subgroup analyses. Main outcome was relapse rate at last follow-up (PROSPERO ID: CRD42020149326). RESULTS: Of 10 randomized controlled trials (RCTs) that examined depression, 9 were eligible for analysis: 4 included psychological interventions (n = 370), 3 included antidepressants (n = 80), and 2 included combinations (n = 132). No RCTs for anxiety were identified. Over 6 to 75 months, relapse was half as likely following psychological treatment compared with care as usual conditions (k = 6; odds ratio 0.56, 95% CI 0.31 to 1.00). Sensitivity analyses including only studies with ≥50 participants (k = 3), showed similar results. Over 6 to 12 months, relapse was less likely in youth receiving antidepressants compared with youth receiving pill placebo (k = 3; OR 0.29, 95% CI 0.10 to 0.82). Quality of studies was suboptimal. CONCLUSION: Relapse prevention strategies for youth depression reduce risk of relapse, although adequately powered, high-quality RCTs are needed. This finding, together with the lack of RCTs on anxiety, underscores the need to examine relapse prevention in youth facing these common mental health conditions.
Reference:
Meta-Analysis: Relapse Prevention Strategies for Depression and Anxiety in Remitted Adolescents and Young Adults. (Robberegt, Suzanne J., Brouwer, Marlies E., Kooiman, Bas E. A. M., Stikkelbroek, Yvonne A. J., Nauta, Maaike H. and Bockting, Claudi L. H.), In Journal of the American Academy of Child and Adolescent Psychiatry, 2022.
Bibtex Entry:
@article{robberegt_meta-analysis_2022,
	title = {Meta-{Analysis}: {Relapse} {Prevention} {Strategies} for {Depression} and {Anxiety} in {Remitted} {Adolescents} and {Young} {Adults}.},
	copyright = {Copyright © 2022 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.},
	issn = {1527-5418 0890-8567},
	doi = {10.1016/j.jaac.2022.04.014},
	abstract = {OBJECTIVE: Depression and anxiety cause a high burden of disease and have high relapse rates (39%-72%). This meta-analysis systematically examined effectiveness  of relapse prevention strategies on risk of and time to relapse in youth who  remitted. METHOD: PubMed, PsycInfo, Embase, Cochrane, and ERIC databases were  searched up to June 15, 2021. Eligible studies compared relapse prevention  strategies to control conditions among youth (mean age 13-25 years) who were  previously depressed or anxious or with ≥30% improvement in symptoms. Two  reviewers independently assessed titles, abstracts, and full texts; extracted  study data; and assessed risk of bias and overall strength of evidence.  Random-effects models were used to pool results, and mixed-effects models were  used for subgroup analyses. Main outcome was relapse rate at last follow-up  (PROSPERO ID: CRD42020149326). RESULTS: Of 10 randomized controlled trials (RCTs)  that examined depression, 9 were eligible for analysis: 4 included psychological  interventions (n = 370), 3 included antidepressants (n = 80), and 2 included  combinations (n = 132). No RCTs for anxiety were identified. Over 6 to 75 months,  relapse was half as likely following psychological treatment compared with care  as usual conditions (k = 6; odds ratio 0.56, 95% CI 0.31 to 1.00). Sensitivity  analyses including only studies with ≥50 participants (k = 3), showed similar  results. Over 6 to 12 months, relapse was less likely in youth receiving  antidepressants compared with youth receiving pill placebo (k = 3; OR 0.29, 95%  CI 0.10 to 0.82). Quality of studies was suboptimal. CONCLUSION: Relapse  prevention strategies for youth depression reduce risk of relapse, although  adequately powered, high-quality RCTs are needed. This finding, together with the  lack of RCTs on anxiety, underscores the need to examine relapse prevention in  youth facing these common mental health conditions.},
	language = {eng},
	journal = {Journal of the American Academy of Child and Adolescent Psychiatry},
	author = {Robberegt, Suzanne J. and Brouwer, Marlies E. and Kooiman, Bas E. A. M. and Stikkelbroek, Yvonne A. J. and Nauta, Maaike H. and Bockting, Claudi L. H.},
	month = may,
	year = {2022},
	pmid = {35513189},
	note = {Place: United States},
	keywords = {anxiety disorders, depressive disorders, intervention, meta-analysis, relapse prevention},
	pages = {S0890--8567(22)00244--1},
}