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Even Mild Sadness, Stresses May Re-Trigger Depression

In some recovered patients, increased cognitive reactivity may predict depression relapse

THURSDAY, July 6 (HealthDay News) -- In some patients who have recovered from depression, even mild stresses and sadness can reactivate depressive thinking styles and increase the risk of relapse, according to a study in the July issue of the Archives of General Psychiatry.

Zindel V. Segal, Ph.D., of the University of Toronto Centre for Addiction and Mental Health in Ontario, Canada, and colleagues conducted a two-phase study of 301 patients with major depressive disorder. In phase one, the patients were randomly assigned to receive either antidepressant medications or cognitive behavioral therapy. In phase two, 78 patients who achieved remission underwent sad-mood provocation and were followed for 18 months.

During phase two, the researchers found relapse rates of 47.5 percent in the patients who had recovered through antidepressant medication use and 39 percent in those who had received cognitive behavioral therapy. Patients who had greater cognitive reactivity after the sad-mood provocation were more likely to relapse, and those whose scores increased at least eight points in an assessment of mood-linked endorsement of dysfunctional attitudes were likely to relapse more quickly than those whose scores were not as elevated.

"Further understanding of factors predisposing to relapse/recurrence in recovered patients may help to shorten the potentially lifelong course of depression," the authors conclude.

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