de Klerk-Sluis JM, Huijbers MJ, Löcke S, et al. - For relapse prevention in major depressive disorder (MDD), an effective therapy is mindfulness-based cognitive therapy (MBCT), which lowers cognitive reactivity (CR) and rumination, and improves self-compassion and mindfulness. Although relapse has been observed in correlation with rumination and mindfulness after MBCT, there exists no investigation concerning the association of CR, rumination, self-compassion, and mindfulness with relapse prior to initiation of MBCT.

• For this study, researchers analyzed data collected during two randomized controlled trials, including a total of 282 remitted MDD patients (≥ 3 depressive episodes) who had been taking maintenance antidepressant medication (mADM) for at least 6 months before baseline.

• MBCT was offered to all participants while either their mADM was maintained or discontinued after MBCT.

• Relapse appeared in correlation with CR and mindfulness, independent of residual symptoms, previous depressive episodes, and mADM-use.

• An increased risk of relapse was observed in correlation with higher CR and lower mindfulness.

• No association of self-compassion was observed with relapse.

• There appeared a significant interaction of rumination with mADM-use.

• Patients who discontinued their mADM, but not those who continued mADM, showed association of rumination with relapse.