Psicothema was founded in Asturias (northern Spain) in 1989, and is published jointly by the Psychology Faculty of the University of Oviedo and the Psychological Association of the Principality of Asturias (Colegio Oficial de Psicología del Principado de Asturias).
We currently publish four issues per year, which accounts for some 100 articles annually. We admit work from both the basic and applied research fields, and from all areas of Psychology, all manuscripts being anonymously reviewed prior to publication.
Maider Prieto-Vila, Francisco José Estupiñá, and Antonio Cano-Vindel
Universidad Complutense de Madrid
Background: Major Depressive Disorder (MDD) is highly recurrent. Most patients with MDD are treated in the Primary Care (PC) setting. The purpose of this systematic review was to identify risk factors associated with relapse of MDD in PC. Method: A systematic review of PsycINFO, PubMed, Web of Science and ScienceDirect, from 1978 to 2019, following PRISMA guidelines was conducted. Results: Eight studies fulfilling the eligibility criteria and 12 risk factors associated with relapse of MDD were found. Patients who showed a higher frequency of relapse were: 1) those with higher scores in neuroticism, disability, current MDD episode severity, and childhood abuse; 2) lower scores on extraversion, self-esteem, emotional role, physical functioning; 3) history of MDD relapse; 4) comorbidity; and 5) poorer adherence to antidepressant medication (ADM). In terms of treatment, ADM combined with cognitive behavioural therapy and psychoeducation was reported to produce fewer relapses, as was mindfulness-based cognitive therapy for patients with a higher score in childhood abuse. Conclusions: Despite the very varied nature of the studies, different risk factors associated with relapse were identified. However, more research is needed on this important problem, with randomized controlled trials.
Factores de Riesgo Asociados con Recaída en el Trastorno Depresivo Mayor en Atención Primaria: una Revisión Sistemática. Antecedentes: el Trastorno Depresivo Mayor (TDM) es altamente recurrente. La mayoría de los pacientes con TDM son tratados en Atención Primaria (AP). Por ello, el objetivo de esta revisión sistemática fue identificar factores de riesgo relacionados con la recaída del TDM en AP. Método: se realizó una revisión sistemática de PsycINFO, PubMed, Web of Science y ScienceDirect, desde 1978 a 2019, siguiendo las pautas PRISMA. Resultados: ocho estudios cumplieron criterios de elegibilidad identificando 12 factores de riesgo asociados con recaída del TDM. Los pacientes que mostraron mayor frecuencia de recaída fueron: 1) aquellos que mostraron mayor puntuación en neuroticismo, discapacidad, severidad previa del TDM, abusos en la infancia; 2) menor puntuación en extraversión, autoestima, rol emocional, funcionamiento físico; 3) antecedentes de recaída del TDM; 4) comorbilidad; y 5) peor adherencia a la medicación antidepresiva (MAD). En cuanto al tipo de tratamiento, MAD con terapia cognitivo conductual y psicoeducación reportaron menos recaídas y el tratamiento cognitivo basado en mindfulness para pacientes con mayor puntuación en abusos en la infancia. Conclusiones: pese a la alta heterogeneidad de los estudios, se identificaron diferentes factores de riesgo asociados con recaída; sin embargo, se necesita más investigación con ensayos controlados aleatorios centrados en este problema.
SPANISH
ENGLISH
https://doi.org/10.7334/psicothema2020.186