New Psycho therapeutic Approaches to Residual Symptoms and Relapse Prevention in Unipolar Depression

Relapse and recurrence are vexing problems of unipolar depression. Awareness of their frequent occurrence has led to the development of pharmacological long-term strategies. A substantial proportion of patients with mood disorders still display residual symptoms upon successful treatment of their illness. Such symptoms were found to entail prognostic value in the prediction of relapse in the entire range of affective disorders. Specific psychotherapeutic strategies for this stage of illness have been developed. One involves cognitive-behavioral treatment of residual symptoms after successful pharmacological therapy of acute depression. This strategy has resulted in a lower relapse rate at a four-year follow-up compared to a clinical management group. The other strategy, based on Ryff's conceptual model, was developed to enhance well-being (well-being therapy). Results from recent pilot studies indicate that well-being therapy maybe a promising strategy for decreasing residual symptomatology in affective disorders and thus as a relapse-preventive strategy.