Mode
Text Size
Log in / Sign up

Internet-based CBT relapse predictors in remitted major depressive disorder patientsFor those who beat depression with online therapy, what risks relapse and how to stay well?

AI-generated summary of the cited source, checked by automated accuracy review. How we work

Key Takeaway
Consider structured relapse prevention for ICBT patients, especially those with childhood maltreatment history or adverse life events.

This study presents a secondary analysis of a randomized controlled trial involving 83 remitted patients with major depressive disorder. The primary outcome assessed was the relapse rate over a 12-month follow-up period. Secondary outcomes included predictors of time-to-relapse.

The analysis found a relapse rate of 37.1% within 12 months. Several factors were identified as significant predictors. A history of childhood maltreatment was associated with an increased risk of relapse, with a hazard ratio of 14.001 (p = 0.019). Experiencing more adverse life events also increased relapse risk, with a hazard ratio of 1.331 (p = 0.003). Additionally, not seeking mental healthcare services when needed at follow-up was linked to a higher relapse risk, with a hazard ratio of 5.114 (p = 0.049).

Conversely, conscientiously completing the intervention was associated with a lower risk of relapse, showing a hazard ratio of 0.386 (p = 0.039). No data on adverse events, serious adverse events, discontinuations, or tolerability were reported. The study notes that few investigations have specifically looked at relapse rates and risk factors following successful ICBT.

Practice relevance suggests that structured relapse prevention strategies are necessary. Emphasis should be placed on conscientiously completing therapeutic courses and promptly seeking mental healthcare services when needed, especially for those with childhood maltreatment experience or those undergoing more adverse life events.

Imagine you have finally beaten the fog of major depression using an online therapy program. You feel better, but the study shows that for many, the journey isn't over. Within 12 months, roughly 37% of people who had achieved remission saw their symptoms return. This is a real possibility that needs honest attention, not fear.

The research looked at 83 people who had successfully treated their depression with internet-based cognitive behavioral therapy. They tracked these patients for a full year to see who would slip back into struggling with their mood. The team found that finishing the therapy program carefully was a strong shield against returning symptoms. Those who completed the work had a much lower chance of relapse.

However, some life factors made returning harder. People with a history of childhood maltreatment were far more likely to relapse. Those facing more tough life events also faced higher risks. Perhaps most importantly, skipping mental health care when you needed it during that year made relapse much more likely. These are honest signals about what keeps people safe.

The study admits that few others have looked so closely at these specific risks after online therapy. This means we are learning as we go. The takeaway is clear: structured plans to prevent relapse are necessary. Focus on finishing your therapeutic course and asking for help quickly when life gets hard. These steps build a stronger foundation for lasting recovery.

What this means for you:
Finishing your therapy and seeking help early lowers the risk of depression returning.

Study Details

Study typeRct
Sample sizen = 83
EvidenceLevel 2
PublishedApr 2026
View Original Abstract ↓
BACKGROUND: Internet-based cognitive behavioral therapy (ICBT) is a promising intervention for major depressive disorder (MDD) at an aggregated level. However, few studies have investigated the relapse rate and factors predicting risk for relapse following successful ICBT. OBJECTIVES: To examine the relapse rate after ICBT for MDD and identify predictors of time-to-relapse. METHODS: A secondary analysis of a randomized controlled trial was conducted. Participants who remitted after the course were included. The relapse rate was calculated by the Kaplan-Meier method. The Cox proportional hazard model was adopted to investigate the potential associated factors. RESULTS: In total, 83 participants were eligible. The relapse rate was 37.1% within 12 months, with the majority occurring after 6 months. Participants with a history of childhood maltreatment (Hazard ratio, HR = 14.001, p = 0.019), experiencing more adverse life events (HR = 1.331, p = 0.003), and not seeking mental healthcare services when needed at follow-up (HR = 5.114, p = 0.049) were more likely to relapse, while for those conscientiously completing the intervention, a lower risk was found (HR = 0.386, p = 0.039). CONCLUSION: Structured relapse prevention strategies are necessary, especially for those with childhood maltreatment experience and undergoing more adverse life events. Emphasis should be put on conscientiously completing therapeutic courses and promptly seeking mental healthcare services when needed.
Free Newsletter

Clinical research that matters. Delivered to your inbox.

Join thousands of clinicians and researchers. No spam, unsubscribe anytime.