An Individual Participant Data meta-analysis of psychological interventions for preventing depressive relapse

This is the author accepted manuscript.Data availability: This is individual participant data from randomised controlled trials which cannot be shared publicly due to ethical and consent restrictions that are in place. For data access, please contact the corresponding author. Data access can be provided if these conditions are met 1) there is approval from all co-authors for the data to be shared, 2) there is a data sharing agreement in place (which adheres to the requirements for data sharing by the Amsterdam University Medical Centre), 3) individual studies have participant consent and ethics approvals in place to allow for further onward sharing 4) there is an analysis plan in place that all co-authors agree with. Upon data sharing data can only be used for the specified purposes.Code availability: Analysis code can be found here: https://osf.io/fyr7hMajor depressive disorder (MDD) is a leading cause of disability worldwide, identifying effective strategies to prevent depressive relapse is crucial. This individual patient data meta-analysis (IPDMA) addresses whether and for whom psychological interventions can be recommended for relapse prevention of MDD. One and two-stage IPDMA on 14 randomised controlled trials (N = 1720) were conducted. The relapse risk over 12 months was substantially lower for those who received a psychological intervention versus treatment as usual (TAU), antidepressant or evaluation only control (Hazard Ratio (HR): 0.60 (95% CI 0.48 – 0.74). The number of previous depressive episodes moderated the treatment effect, with psychological interventions demonstrating greater efficacy for patients with three or more prior episodes. Our results suggest that adding psychological interventions to current treatment in order to prevent depressive relapse is recommended. For patients at lower risk of relapse, less intensive approaches may be indicated.Alliance for Public Health, Amsterdam University Medical Centr