Prevention of Recurrent Depression With Cognitive Behavioral Therapy

We read with interest the article by Fava et al¹ on the prevention of recurrent depression with cognitive behavioral therapy and welcome the study for addressing a neglected but important area. While the long-term use of antidepressants as prophylaxis is a very important management strategy, it does have some limitations that include the reluctance of many patients to take antidepressants on a long-term basis; possible adverse effects (even the selective serotonin reuptake inhibitors can have important adverse effects such as sexual dysfunction); the occurrence of relapse in some patients even with continued medication; and the possibility of residual symptoms and impairment in function even without an actual depressive episode. In view of these factors and the demonstrated efficacy of cognitive behavioral therapy in depressive disorders, its adequate evaluation for prophylaxis in depressive disorders has been long overdue and the present study is an important contribution in this direction. It is not unlikely that in the next few years cognitive behavioral therapy and, perhaps, other modalities of psychotherapy may be shown to have an important role in the continuation and maintenance treatment of depressive disorders.