Mindfulness-Based Cognitive Therapy May Reduce Relapse in MDD Patients

A meta-analysis published today in JAMA Psychiatry suggests that mindfulness-based cognitive therapy (MBCT) may be just as or more effective in preventing or delaying relapse in patients with recurrent major depressive disorder (MDD) than other types of depression therapies, especially in individuals with pronounced residual symptoms.

MBCT combines the concepts of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness.

“Relapse prevention in recurrent depression is a significant public health problem, and antidepressants are the current first-line treatment approach,” wrote an international team of study authors. “Identifying an equally efficacious nonpharmacological intervention would be an important development.”

For the study, the researchers performed a systematic review of randomized trials published from November 2010 to November 2014. To meet inclusion, studies were required to have compared the effectiveness of MBCT with at least one non-MBCT treatment, such as antidepressant treatment and cognitive psychological education, to prevent symptom relapse in adults with recurrent MDD who were in full or partial remission.

The effectiveness of MBCT treatment was measured by the absence of relapse to depression within 60 weeks of follow-up, measured by the Structured Clinical Diagnostic Interview. The researchers also examined the impact of sociodemographic factors and psychiatric variables on MBCT effectiveness.

Nine trials met inclusion in the meta-analysis, with a total of 1,258 participants. Of the participants who received MBCT, 38 percent had a depressive relapse within the 60-week follow-up, compared with 49 percent among those who did not receive MBCT. Results also showed MBCT to be more effective in people presenting greater depressive symptoms at baseline, compared with those who did not. There was no statistical correlation between MBCT and age, sex, education, or relationship status.

In an accompanying editorial, Richard Davidson, Ph.D., founder of the Center for Healthy Minds at the University of Wisconsin-Madison, wrote that “the opportunity now is to examine in more detail which types of patients benefit most from MBCT, the mechanisms by which MBCT is producing its beneficial change, and how we can better measure the mediators of therapeutic change.”

For related information, read the Psychiatric News article "Mindfulness Program Found to Help Urban Children Cope With Stress."

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