Claudi L H Bockting

University Medical Centers Amsterdam · Psychiatry Department

Background: Keeping individuals on antidepressants after remission or recovery of major depressive disorder is a common strategy to prevent relapse or recurrence. Preventive cognitive therapy (PCT) has been proposed as an alternative to maintenance antidepressant treatment, but whether its addition would allow tapering of antidepressants or enhanc...

Background Research in depression has progressed rapidly over the past four decades. Yet depression rates are not subsiding and treatment success is not improving. We examine the extent to which the gap between science and practice is associated with the level of integration in how depression is considered in research and stakeholder-relevant docum...

The science of dynamic systems is the study of pattern formation and system change. Dynamic systems theory can provide a useful framework for understanding the chronicity of depression and its treatment. We propose a working model of therapeutic change with potential to organize findings from psychopathology and treatment research, suggest new ways...

Background: Psychological treatments occupy an important place in evidence-based mental health treatments. Now is an exciting time to fuel treatment research: a pressing demand for improvements is poised alongside new opportunities from closer links with sister scientific and clinical disciplines. The need to improve mental health treatment is grea...

Purpose of this review To review and reconcile the methodologies and understandings of metacognition from both cognitive science and psychopathology in Gaming Disorder and Gambling Disorder to enhance interdisciplinary communication and methodological exchange. Recent findings While clinical metacognition research in gaming and gambling disorders...

Background Technology improves accessibility of psychological interventions for youth. An ecological momentary intervention (EMI) is a digital intervention geared toward intervening in daily life to enhance the generalizability and ecological validity, and to be able to intervene in moments most needed. Identifying working mechanisms of the use of...

Young adult suicidality is worldwide a prevalent mental health problem and the number one cause of death, with devastating consequences for individuals and their families, and substantial economic costs. However, psychological and pharmacological treatments currently recommended in guidelines for treatment of high-risk youth for fatal suicide have...

Importance Psychiatric disorders may come and go with symptoms changing over a lifetime. This suggests the need for a paradigm shift in diagnosis and treatment. Here we present a fresh look inspired by dynamical systems theory. This theory is used widely to explain tipping points, cycles, and chaos in complex systems ranging from the climate to eco...

Importance Dynamical systems theory is widely used to explain tipping points, cycles, and chaos in complex systems ranging from the climate to ecosystems. It has been suggested that the same theory may be used to explain the nature and dynamics of psychiatric disorders, which may come and go with symptoms changing over a lifetime. Here we review ev...

Background Southeast Asia has the highest suicide mortality worldwide. To improve our knowledge on the effectiveness of interventions for suicidal ideation (SI) in individuals with depression in Indonesia, we conducted a secondary analysis of a randomised controlled trial. Objective We explored whether an internet-based behavioural activation (BA)...

Background Major Depressive Disorder (MDD) is one of the most prevalent psychiatric disorders, and involves high relapse rates in which persistent negative thinking and rumination (i.e., perseverative cognition [PC]) play an important role. Positive fantasizing and mindfulness are common evidence-based psychological interventions that have been sho...

This paper describes the implementation of inflammatory bowel disease (IBD)-specific cognitive behavioural therapy (CBT) for IBD patients with poor quality of life (QoL), anxiety and depression, in four hospitals in the Netherlands. Treatment outcomes were compared with those of a previously published randomized control trial (RCT) of ‘IBD-specific...

Background The highly recurrent nature of Major Depressive Disorder is a major contributor to disability and health care costs. Several studies indicate that recurrence may be prevented with Preventive Cognitive Therapy (PCT). This study is the first to perform an economic evaluation of PCT in comparison with care as usual for recurrently depressed...

Major depressive disorder is a leading cause of disability worldwide; identifying effective strategies to prevent depression relapse is crucial. This individual participant data meta-analysis addresses whether and for whom psychological interventions can be recommended for relapse prevention of major depressive disorder. One- and two-stage individu...

Background There is an urgent need to better understand and prevent relapse in major depressive disorder (MDD). We explored the differential impact of various MDD relapse prevention strategies (pharmacological and/or psychological) on affect fluctuations and individual affect networks in a randomised setting, and their predictive value for relapse....

Background A comprehensive picture is lacking of the impact of early childhood (age 0–5) risk factors on the subsequent development of mental health symptoms. Objective In this systematic review, we investigated which individual, social and urban factors, experienced in early childhood, contribute to the development of later anxiety and depression...

Importance Targeting low self-esteem in youth exposed to childhood adversity is a promising strategy for preventing adult mental disorders. Ecological momentary interventions (EMIs) allow for the delivery of youth-friendly, adaptive interventions for improving self-esteem, but robust trial-based evidence is pending. Objective To examine the effica...

Background Depression is a highly common and recurrent condition. Predicting who is at most risk of relapse or recurrence can inform clinical practice. Applying machine-learning methods to Individual Participant Data (IPD) can be promising to improve the accuracy of risk predictions. Methods Individual data of four Randomized Controlled Trials (RC...

Question Partial remission of major depressive disorder (MDD) is a debilitating and distressing clinical state related to chronicity, morbidity and relapse. Although one-third of patients remit partially, evidence for treatment efficacy is unclear. We provide an overview of treatment options and their efficacy. Study selection and analysis Embase,...

The use of online mental health consultation is increasing in Indonesia, especially since the Covid-19 pandemic. This study investigates the benefits and challenges in implementing online mental health consultation in Indonesia, from the practitioners’ perspectives. A total of 210 mental health practitioners participated in this online survey study...

Tailoring interventions to the individual has been hypothesized to improve treatment efficacy. Personalization of target-specific underlying mechanisms might improve treatment effects as well as adherence. Data-driven personalization of treatment, however, is still in its infancy, especially concerning the integration of multiple sources of data-dr...

Introduction: Different types of psychotherapy are effective for treating major depressive disorder across groups yet show large within-group differences. Patient personality style is considered a potentially useful variable for treatment matching. Objective: This study is the first experimental test of the interaction between therapeutic approa...

Background: The recurrent nature of Major Depressive Disorder (MDD) asks for a better understanding of mechanisms underlying relapse. Previously, self-referential processing abnormalities have been linked to vulnerability for relapse. We investigated whether abnormalities in self-referential cognitions and functioning of associated brain-networks...

Introduction: This study examines the performance of active learning-aided systematic reviews using a deep learning-based model compared to traditional machine learning approaches, and explores the potential benefits of model-switching strategies. Methods: Comprising four parts, the study: 1) analyzes the performance and stability of active lear...

Background: Alterations in stress regulation and function of the hypothalamic-pituitary-adrenal (HPA) axis during infancy may be a risk factor for the development of psychopathology later in life. Maternal childhood trauma, depression, anxiety and stressful life events are individually associated with HPA axis dysregulation. Less is known about th...

Background The COVID-19 pandemic has affected people globally both physically and psychologically. The increased demands for mental health interventions provided by clinical psychologists, psychotherapists and mental health care professionals, as well as the rapid change in work setting (e.g., from face-to-face to video therapy) has proven challeng...

Conversational AI is a game-changer for science. Here’s how to respond. Conversational AI is a game-changer for science. Here’s how to respond.

Background: The association between perceived ethnic discrimination (PED) and mental health conditions is well studied. However, less is known about the association between PED and suicidal ideation, or the role of positive psychosocial factors in this association. Aims: To examine the association between PED and suicidal ideation among ethnic m...

Background Patients suffering from major depressive disorder (MDD) regularly experience non-response to treatment for their depressive episode. Personalized clinical decision making could shorten depressive episodes and reduce patient suffering. Although no clinical tools are currently available, machine learning analysis of electroencephalography...

Introduction: Major depressive disorder (MDD) is common, and recurrence rates are high. Preventive Cognitive Therapy (PCT), has been shown to prolong time to recurrence and reduce risk of recurrence(s) over 2-10 years in patients with recurrent depression. Objective: The aim of the study was to examine the effectiveness of PCT over 20 years on t...

Introduction Youth in remission of depression or anxiety have high risks of relapse. Relapse prevention interventions may prevent chronicity. Aim of the study is therefore to (1) examine efficacy of the personalised StayFine app for remitted youth and (2) identify high-risk groups for relapse and resilience. Method and analysis In this Dutch singl...

Background In Major Depressive Disorder (MDD), emotion- and motivation related symptoms may affect effort during neuropsychological testing. Performance Validity Tests (PVT's) are therefore essential, but are rarely mentioned in research on cognitive functioning in MDD. We aimed to assess the proportion of MDD patients with demonstrated valid perfo...

Individuals with autism spectrum disorder (ASD) struggle accessing psychotherapy services for comorbidities, including anxiety-, depressive- and obsessive-compulsive disorders (OCD). Apart from cognitive behavioural therapy (CBT) for anxiety in children with ASD, it is unclear whether psychotherapy is effective for these comorbid disorders. We ther...

The microbiota-gut-brain axis (MGBA) refers to the bidirectional communication between the brain and the gut microbiota and recent studies have linked the MGBA to health and disease. Research has so far investigated this axis mainly from microbiota to brain but less is known about the other direction. One approach to examine the MGBA from brain to...

Background Major Depressive Disorder (MDD) is a prevalent and disabling mental health condition. Patients with MDD often deal with self-stigma, which can lead to more depressive symptoms. Psychoeducation about depression has proven to be effective in reducing depressive symptomatology and self-stigma. Involving a significant other in psychoeducatio...

It is of utmost importance to provide an overview and strength of evidence of predictive factors and to investigate the current state of affairs on evidence for all published and hypothesized factors that contribute to the onset, relapse, and maintenance of anxiety-, substance use-, and depressive disorders. Thousands of such articles have been pub...

Background Patients suffering from major depressive disorder (MDD) regularly experience non-response to treatment for their depressive episode. Personalized clinical decision making could shorten depressive episodes and reduce patient suffering. Although no clinical tools are currently available, machine learning analysis of electroencephalography...

Systematic reviews and meta-analyses are top of the bill in research. However, the screening phase requires an enormous effort in reading and labeling thousands of papers identified via systematic search. Active learning-aided systematic reviewing offers a solution by combining machine learning algorithms with user input to reduce screening load. T...

Background Research suggests that increasing neighbourhood social cohesion can prevent mental health problems, including depression and anxiety. However, it is unknown whether this is the case for adolescents and young adults. Aims To investigate whether neighbourhood social cohesion can prevent depression and anxiety, and identify interventions t...

Background Recent paradigm shifts suggest that psychopathology manifests through dynamic interactions between individual symptoms. Aims To investigate the longitudinal relationships between symptoms in a transdiagnostic sample of patients with psychiatric disorders. Method A two-wave, cross-lagged panel network model of 15 nodes representing symp...

Introduction: Major depressive disorder (MDD) affects 163 million people globally every year. Individuals who experience subsyndromal depressive symptoms during remission (ie, partial remission of MDD) are especially at risk for a return to a depressive episode within an average of 4 months. Simultaneously, partial remission of MDD is associated w...

Mental illness undermines a patient's personal autonomy: the capacities of a person that enables them to live a meaningful life of their own making. So far there has been very little attention given to personal autonomy within psychiatry. This is unfortunate as personal autonomy is disturbed in different ways in psychiatric disorders, and understan...

Objective Depression and anxiety cause a high burden of disease and have high relapse rates (39-72%). In this meta-analysis, we systematically examined effectiveness of relapse prevention strategies on risk of and time to relapse in youth who remitted. Method PubMed, PsycInfo, Embase, Cochrane and Eric were searched up to June 15 2021. Eligible st...

Introduction Each year almost 800.000 people die from suicide, of which up to 87% are affected by major depressive disorder (MDD). Despite the strong association between suicidality and MDD, it remains unknown if suicidal symptoms during remission put remitted recurrent MDD patients (rrMDD) at risk for recurrence. Methods At baseline we compared s...

The recurrent nature of Major Depressive Disorder (MDD) necessitates a better understanding of mechanisms facilitating relapse. MDD has often been associated with abnormal emotion regulation, underpinned by aberrant interactions between the prefrontal cortex and subcortical areas. We assessed whether neural regulation abnormalities remain after rem...

The ability to retrieve specific, single-incident autobiographical memories has been consistently posited as a predictor of recurrent depression. Elucidating the role of autobiographical memory specificity in patient-response to depressive treatments may improve treatment efficacy and facilitate use of science-driven interventions. We used recent m...

Objective: In this paper, we challenge the premise that patients are capable of accurately predicting their emotional response or quality of life in anticipation of health changes. Our goal was to systematically review the published empirical evidence related to the reliability of affective forecasting in the context of medical conditions. Design...

In recent years, network approaches to psychopathology have sparked much debate and have had a significant impact on how mental disorders are perceived in the field of clinical psychology. However, there are many important challenges in moving from theory to empirical research and clinical practice and vice versa. Therefore, in this article, we bri...

Major Depressive Disorder (MDD) is a prevalent psychiatric disorder, characterized by high relapse risk. With every new episode, risk for relapse increases. This makes preventing relapse an important clinical target in limiting the personal and societal burden of MDD. Preventive Cognitive Therapy (PCT) is a protocolized psychological therapy which...

Urbanisation and common mental disorders (CMDs; ie, depressive, anxiety, and substance use disorders) are increasing worldwide. In this Review, we discuss how urbanicity and risk of CMDs relate to each other and call for a complexity science approach to advance understanding of this interrelationship. We did an ecological analysis using data on urb...

Major depression is often a relapsing disorder. It is therefore important to start its treatment with therapies that maximize the chance of not only getting the patients well but also keeping them well. We examined the associations between initial treatments and sustained response by conducting a network meta-analysis of randomized controlled trial...

Background Social stress is an important environmental risk factor for the development of psychiatric disorders, including depression and anxiety disorders. Social stress paradigms are commonly used in rats and mice to gain insight into the pathogenesis of these disorders. The social instability stress (SIS) paradigm entails frequent (up to several...

Background Behavioral activation is an effective treatment for depression that is theorized to facilitate structured increases in enjoyable activities that increase opportunities for contact with positive reinforcement; to date, however, only few mechanistic studies focused on a standalone intervention. Method Interventions using internet-based be...

Background Targeting low self-esteem in youth exposed to childhood adversity is a promising strategy for preventing adult mental disorder, but psychological help remains difficult to access and accept for youth, calling for novel, youth-friendly approaches. Mobile Health (mHealth) and, most prominently, ecological momentary interventions (EMIs) pro...

Objectives: A comprehensive overview of the evidence for factors derived from leading psychological theories of the onset of major depressive disorder (MDD) that underpin psychological interventions is scarce . We aimed to systematically investigate the prospective evidence for factors derived from the behavioural, cognitive, diathesis-stress, psy...

Background Patients with psychiatric disorders often experience cognitive dysfunction, but the precise relationship between cognitive deficits and psychopathology remains unclear. We investigated the relationships between domains of cognitive functioning and psychopathology in a transdiagnostic sample using a data-driven approach. Methods Cross-se...

The ability to retrieve specific, single-incident autobiographical memories has been consistently posited as a predictor of recurrent depression. Elucidating the role of autobiographical memory specificity in patient-response to depressive treatments may improve treatment efficacy and facilitate use of science-driven interventions. We used recent m...

Importance Depression frequently recurs. To prevent relapse, antidepressant medication is often taken in the long term. Sequentially delivering a psychological intervention while undergoing tapering of antidepressant medication might be an alternative to long-term antidepressant use. However, evidence is lacking on which patients may benefit from t...

Background Preliminary evidence suggests beneficial effects of cognitive remediation in depression. An update of the current evidence is needed. The aim was to systematically assess the effectiveness of cognitive remediation in depression on three outcomes. Methods The meta-analysis was pre-registered on PROSPERO (CRD42019124316). PubMed, PsycINFO...

No tools are currently available to predict whether a patient suffering from major depressive disorder (MDD) will respond to a certain treatment. Machine learning analysis of magnetic resonance imaging (MRI) data has shown potential in predicting response for individual patients, which may enable personalized treatment decisions and increase treatm...

Depressive disorder is a recurring condition for many individuals and for some with anxiety disorders. This poses a significant burden on individuals, their significant others and society. Effective and timely interventions are needed in order to minimize the risk of relapse and recurrence. This article provides an overview of the risk of relapse f...