***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
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    Input: Objective : We compared mindfulness-based cognitive therapy ( MBCT ) with both cognitive psychological education ( CPE ) and treatment as usual ( TAU ) in preventing relapse to major depressive disorder ( MDD ) in people currently in remission following at least 3 previous episodes . Method : A r and omized controlled trial in which 274 participants were allocated in the ratio 2:2:1 to MBCT plus TAU , CPE plus TAU , and TAU alone , and data were analyzed for the 255 ( 93 % ; MBCT = 99 , CPE = 103 , TAU = 53 ) retained to follow-up . MBCT was delivered in accordance with its published manual , modified to address suicidal cognitions ; CPE was modeled on MBCT , but without training in meditation . Both treatments were delivered through 8 weekly classes . Results : Allocated treatment had no significant effect on risk of relapse to MDD over 12 months follow-up , hazard ratio for MBCT vs. CPE = 0.88 , 95 % CI [ 0.58 , 1.35 ] ; for MBCT vs. TAU = 0.69 , 95 % CI [ 0.42 , 1.12 ] . However , severity of childhood trauma affected relapse , hazard ratio for increase of 1 st and ard deviation = 1.26 ( 95 % CI [ 1.05 , 1.50 ] ) , and significantly interacted with allocated treatment . Among participants above median severity , the hazard ratio was 0.61 , 95 % CI [ 0.34 , 1.09 ] , for MBCT vs. CPE , and 0.43 , 95 % CI [ 0.22 , 0.87 ] , for MBCT vs. TAU . For those below median severity , there were no such differences between treatment groups . Conclusion : MBCT provided significant protection against relapse for participants with increased vulnerability due to history of childhood trauma , but showed no significant advantage in comparison to an active control treatment and usual care over the whole group of patients with recurrent depression AIMS To assess whether the addition of a mood management component to telephone counselling produces higher abstinence rates in smokers with past major depression and helps to prevent recurrence of depressive symptoms . DESIGN Pragmatic r and omized controlled trial with two conditions , with follow-up at 6 and 12 months . The control intervention consisted of eight sessions of proactive telephone counselling . The mood management intervention was an integration of the control intervention with a mood management component . This component consisted of a self-help mood management manual , two more preparatory proactive telephone counselling sessions and supplementary homework assignments and advice . SETTING Dutch national smoking cessation quitline . PARTICIPANTS A total of 485 daily smokers with past major depression , according to the DSM-IV . MEASUREMENTS The primary outcome measure was prolonged abstinence and secondary outcome measures were 7-day point prevalence abstinence and depressive symptoms . FINDINGS The mood management intervention result ed in significantly higher prolonged abstinence rates at 6- and 12-month follow-up ( 30.5 % and 23.9 % in experimental condition , 22.3 % and 14.0 % in the control condition ) . The odds ratios were 1.60 ( 95 % CI 1.06 - 2.42 ) and 1.96 ( 95 % CI 1.22 - 3.14 ) for both follow-ups . The mood management intervention did not seem to prevent recurrence of depressive symptoms . CONCLUSIONS Adding a mood management component to telephone counselling for smoking cessation in smokers with a past major depression increases cessation rates without necessarily reducing depressive symptoms BACKGROUND Previous studies indicate that depressed patients with partial remission and residual symptoms following antidepressant treatment  are common and have high rates of relapse . There is evidence that cognitive therapy may reduce relapse rates in depression . METHODS One hundred fifty-eight patients with recent major depression , partially remitted with antidepressant treatment ( mean daily doses equivalent to 185 mg of amitriptyline or 33 mg of fluoxetine ) but with residual symptoms of 2 to 18 months ' duration , were included in a controlled trial . Subjects were r and omized to receive clinical management alone or clinical management plus cognitive therapy for 16 sessions during 20 weeks , with 2 subsequent booster sessions . Subjects were assessed regularly throughout the 20 weeks ' treatment and for a further year . They received continuation and maintenance antidepressants at the same dose throughout . RESULTS Cognitive therapy reduced relapse rates for acute major depression and persistent severe residual symptoms , in both intention to treat and treated per protocol sample s. The cumulative relapse rate at 68 weeks was reduced significantly , from 47 % in the clinical management control group to 29 % with cognitive therapy ( hazard ratio 0.54 ; 95 % confidence interval , 0.32 - 0.93 ; intention to treat analysis ) . Cognitive therapy also increased full remission rates at 20 weeks but did not significantly improve symptom ratings . CONCLUSION In this difficult-to-treat group of patients with residual depression who showed only partial response despite antidepressant treatment , cognitive therapy produced worthwhile benefit For people at risk of depressive relapse , mindfulness-based cognitive therapy ( MBCT ) has an additive benefit to usual care ( H. F. Coelho , P. H. Canter , & E. Ernst , 2007 ) . This study asked if , among patients with recurrent depression who are treated with antidepressant medication ( ADM )  , MBCT is comparable to treatment with maintenance ADM ( m-ADM ) in ( a ) depressive relapse prevention , ( b ) key secondary outcomes , and ( c ) cost effectiveness . The study design was a parallel 2-group r and omized controlled trial comparing those on m-ADM ( N = 62 ) with those receiving MBCT plus support to taper/discontinue antidepressants ( N = 61 ) . Relapse/recurrence rates over 15-month follow-ups in MBCT were 47 % , compared with 60 % in the m-ADM group ( hazard ratio = 0.63 ; 95 % confidence interval : 0.39 to 1.04 ) . MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains . There was no difference in average annual cost between the 2 groups . Rates of ADM usage in the MBCT group was significantly reduced , and 46 patients ( 75 % ) completely discontinued their ADM . For patients treated with ADM , MBCT may provide an alternative approach for relapse prevention The authors present follow-up results based on 150 women 1 year after maintenance treatment for depression . Maintenance treatment consisted of 8 months of amitriptyline , psychotherapy , or a combination of the two , administered by r and om assignment following recovery from an acute depressive episode . Approximately 30 % of the patients remained in complete remission , 60 % experienced recurrence of symptoms , and 12 % remained mildly but chronically symptomatic . The implication s of these findings for planning care for the ambulatory depressed patient on both an individual and a public health basis are discussed Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more CONTEXT Few depressed older adults receive effective treatment in primary care setting s. OBJECTIVE To determine the effectiveness of the Improving Mood-Promoting Access to Collaborative Treatment ( IMPACT ) collaborative care management program for late-life depression .  DESIGN R and omized controlled trial with recruitment from July 1999 to August 2001 . SETTING Eighteen primary care clinics from 8 health care organizations in 5 states . PARTICIPANTS A total of 1801 patients aged 60 years or older with major depression ( 17 % ) , dysthymic disorder ( 30 % ) , or both ( 53 % ) . INTERVENTION Patients were r and omly assigned to the IMPACT intervention ( n = 906 ) or to usual care ( n = 895 ) . Intervention patients had access for up to 12 months to a depression care manager who was supervised by a psychiatrist and a primary care expert and who offered education , care management , and support of antidepressant management by the patient 's primary care physician or a brief psychotherapy for depression , Problem Solving Treatment in Primary Care . MAIN OUTCOME MEASURES Assessment s at baseline and at 3 , 6 , and 12 months for depression , depression treatments , satisfaction with care , functional impairment , and quality of life . RESULTS At 12 months , 45 % of intervention patients had a 50 % or greater reduction in depressive symptoms from baseline compared with 19 % of usual care participants ( odds ratio [ OR ] , 3.45 ; 95 % confidence interval [ CI ] , 2.71 - 4.38 ; P<.001 ) . Intervention patients also experienced greater rates of depression treatment ( OR , 2.98 ; 95 % CI , 2.34 - 3.79 ; P<.001 ) , more satisfaction with depression care ( OR , 3.38 ; 95 % CI , 2.66 - 4.30 ; P<.001 ) , lower depression severity ( range , 0 - 4 ; between-group difference , -0.4 ; 95 % CI , -0.46 to -0.33 ; P<.001 ) , less functional impairment ( range , 0 - 10 ; between-group difference , -0.91 ; 95 % CI , -1.19 to -0.64 ; P<.001 ) , and greater quality of life ( range , 0 - 10 ; between-group difference , 0.56 ; 95 % CI , 0.32 - 0.79 ; P<.001 ) than participants assigned to the usual care group . CONCLUSION The IMPACT collaborative care model appears to be feasible and significantly more effective than usual care for depression in a wide range of primary care practice The objective of the study was to investigate the long-term effects of  internet-based relapse prevention  for sufferers of partially remitted depression . Eighty-four individuals with partially remitted unipolar depression were r and omized to either internet-based CBT ( iCBT ) or to a control group . After the ten week intervention period the participants were followed for 24 months and diagnostic interviews conducted to detect relapse . The intervention and monthly self-ratings of depressive symptoms were administered via an internet-based platform that ensured secure communication with all participants . Significantly fewer participants in the iCBT group had experienced a relapse compared with those in the control group two years after the internet-based intervention . The relapse rate in the iCBT group was 13.7 % ( CI 95%=2.5 - 24.9 ) and in the control group it was 60.9 % ( CI 95%=44.8 - 77 ) . Furthermore , a significantly larger proportion of the iCBT group experienced remission two years after the intervention compared with the control group . Internet-based CBT seems promising for preventing relapse in sufferers of partially remitted depression BACKGROUND Cognitive therapy ( CT ) may reduce depressive relapse and recurrence when patients learn and use the associated skills . Reported relapse and recurrence rates after CT discontinuation vary widely . The factors that determine when CT is preventive remain unidentified . We developed continuation-phase CT ( C-CT ) to teach responders skills to prevent relapse . This is the first r and omized trial comparing CT with and without a continuation phase in responders to CT who were vulnerable , given their history of recurrent unipolar depression . METHODS Patients aged 18 to 65 years ( n = 156 ) with recurrent DSM-IV major depressive disorder ( MDD ) entered 20 sessions of acute-phase CT ( A-CT ) . Unmedicated responders ( ie , no MDD and 17-item Hamilton Rating Scale for Depression score < or = 9 ; n = 84 ) were r and omized to either 8 months ( 10 sessions ) of C-CT or control ( evaluation without CT ) . Follow-up lasted an additional 16 months . A clinician blind to assignment evaluated relapse and recurrence ( ie , DSM-IV MDD ) . RESULTS Over an 8-month period , C-CT significantly reduced relapse estimates more than control ( 10 % vs 31 % ) . Over 24 months , including the CT-free follow-up , age of onset and quality of remission during the late phase of A-CT each interacted with condition assignment to influence durability of effects . In patients with early-onset MDD , C-CT significantly reduced relapse and recurrence estimates ( 16 % vs 67 % in control ) . When patients had unstable remission during late A-CT , C-CT significantly reduced relapse and recurrence estimates to 37 % ( vs 62 % in control ) . CONCLUSIONS Findings suggest that 8 months of C-CT significantly reduces relapse and recurrence in the highest-risk patients with recurrent MDD . Risk factors influenced the necessity for C-CT Recovered recurrently depressed patients were r and omized to treatment as usual ( TAU ) or TAU plus mindfulness-based cognitive therapy ( MBCT ) . Replicating previous findings , MBCT reduced relapse from 78 % to 36 % in 55 patients with 3 or more previous episodes ; but in 18 patients with only 2 ( recent ) episodes corresponding figures were 20 % and 50 % . MBCT was most effective in preventing relapses not 
    Output:
    
The effect was maintained at 24months for CBT , but not for IPT despite ongoing sessions .
A key area of heterogeneity differentiating these groups was prior acute treatment .
Other psychological therapies and service-level programmes varied in efficacy .
CONCLUSION AND IMPLICATION S Psychological interventions may prolong the recovery a person has achieved through use of medication or acute psychological therapy .
Although there was evidence that MBCT is effective , it was largely tested following medication , so its efficacy following psychological interventions is less clear .
IPT was only tested following acute IPT .