Under pressure

Depression is highly prevalent disorder and is associated with a high disease burden for people themselves and their environment. To many people, depression does not occur just once in a lifetime, but is a highly recurrent condition. In this thesis, entitled 'Under pressure', we examined potential risk factors of depressive relapse and how to prevent relapse in people with recurrent depression(s). 

Potential risk factors

For people who had experienced previous episodes of depression, daily hassles were associated with a poorer course of depression. Further, we demonstrated that the presence of a possible personality disorder was associated with increased levels of cognitive vulnerability (e.g. more rumination). Being exposed to childhood trauma and the presence of a chronic somatic illness, were not associated with a poorer depression course.

Prevention of relapse

Psychological therapies, offered during (partial) remission, seem effective in reducing the risk of depressive relapse, also for people with relatively few previous episodes. Prevention of relapse is therefore important to anyone who has experienced depression. To increase the accessibility of care, Internet-based therapies could be of importance. Results demonstrated that, in addition to regular treatment, an Internet-based preventive cognitive treatment with minimal therapist support and mood monitoring (Mobile Cognitive Therapy) is an effective and acceptable way of preventing an increase in depressive symptomatology after remission in recurrently depressed individuals.

Possibly not everyone needs the same type and form of treatment.  Personalized treatment based on specific risk factors within an individual might help in providing the best possible prevention of relapse.