The mindfulness-based cognitive therapy approach was compared to usual care with the results comparable to other active treatments, as measured over a five month period.
Recurrent depression is a serious issues as it causes significant disability. Interventions that prevent depressive relapse could help reduce the burden of this disease.
A growing body of research suggests mindfulness-based cognitive therapy (MBCT) is efficacious.
In the study, researchers reviewed the results of analyses of individual patient data from nine published randomized trials of MBCT. The analyses included 1,258 patients with available data on relapse and examined the efficacy of MBCT compared with usual care and other active treatments, including antidepressants.
From the review, Willem Kuyken, Ph.D., of the University of Oxford, England, and coauthors report MBCT was associated with reduced risk of depressive relapse/recurrence over 60 weeks compared with those who did not receive MBCT.
Investigators also discovered that the technique is robust as it is equally effective for a variety of groups regardless of sex, age, education, or relationship status.
The treatment effect of MBCT on the risk of depressive relapse/recurrence also may be larger in patients with higher levels of depression symptoms at baseline compared with non-MBCT treatments. This finding suggests that MBCT may be especially helpful to those patients who still have significant depressive symptoms.
Nevertheless, the authors acknowledge study limitations related to the availability of the data within the studies.
“We recommend that future trials consider an active control group, use comparable primary and secondary outcomes, use longer follow-ups, report treatment fidelity, collect key background variables (e.g., race/ethnicity and employment), take care to ensure generalizability, conduct cost-effectiveness analyses, put in place ethical and data management procedures that enable data sharing, consider mechanisms of action, and systematically record and report adverse events,” the authors conclude.
The study and accompanying editorial appear in JAMA Psychiatry.
Editorial: Mindfulness-Based Cognitive Therapy, Prevention of Depressive Relapse
“Mindfulness practices were not originally developed as therapeutic treatments. They emerged originally in contemplative traditions for the purposes of cultivating well-being and virtue. The questions of whether and how they might be helpful in alleviating symptoms of depression and other related psychopathologies are quite new, and the evidence base is in its embryonic stage.
“To my knowledge, the article by Kuyken et al is the most comprehensive meta-analysis to date to provide evidence for the effectiveness of MBCT in the prevention of depressive relapse.
“However, the article also raises many questions, and the limited nature of the extant evidence underscores the critical need for additional research,” writes Richard J. Davidson, Ph.D., of the University of Wisconsin-Madison.