Huidige behandeling van depressie is weggegooid geld

Depression is a chronic illness with a highly recurrent course, since relapse rates rise up to 90% after multiple previous episodes. In the Netherlands the costs originating from depression are high. The current treatment costs accumulate up to 660 million euro's, and the costs related to loss of productivity rise to 950 million euro's each year. The guidelines of the American Psychiatric Association advices therapists to continue treatment until a patient is completely symptom free, since residual symptoms are a known predictor of relapse. However, due to changes in financing the mental healthcare system therapists are stimulated to end treatment soon. By neglecting the risk of relapse, the current treatment of depression is a waste of money. Currently, the most used strategy to prevent relapse in depression is continuation of antidepressants after remission. However, most patients are not able or willing to continue antidepressants lifelong. Cognitive therapy has prophylactic effects beyond the acute phase of depression. Specific preventive cognitive therapy offered after remission, either in group format or via the internet could prove to be a cost-effective alternative for antidepressants in preventing relapse, since it has shown to prevent relapse in previous studies.