Mindfulness-based cognitive therapy to prevent relapse in recurrent depression.
For people at risk of depressive relapse, mindfulness-based cognitive therapy (MBCT) has an additive benefit to usual care (H. F. Coelho, P. H. Canter, & E. Ernst, 2007). This study asked if, among patients with recurrent depression who are treated with antidepressant medication (ADM), MBCT is comparable to treatment with maintenance ADM (m-ADM) in (a) depressive relapse prevention, (b) key secondary outcomes, and (c) cost effectiveness. The study design was a parallel 2-group randomized controlled trial comparing those on m-ADM (N = 62) with those receiving MBCT plus support to taper/discontinue antidepressants (N = 61). Relapse/recurrence rates over 15-month follow-ups in MBCT were 47%, compared with 60% in the m-ADM group (hazard ratio = 0.63; 95% confidence interval: 0.39 to 1.04). MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains. There was no difference in average annual cost between the 2 groups. Rates of ADM usage in the MBCT group was significantly reduced, and 46 patients (75%) completely discontinued their ADM. For patients treated with ADM, MBCT may provide an alternative approach for relapse prevention.
Kuyken
Willem
W
Mood Disorders Centre, University of Exeter, Exeter, Devon, UK. w.kuyken@exeter.ac.uk
Byford
Sarah
S
Taylor
Rod S
RS
Watkins
Ed
E
Holden
Emily
E
White
Kat
K
Barrett
Barbara
B
Byng
Richard
R
Evans
Alison
A
Mullan
Eugene
E
Teasdale
John D
JD
D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D001364:Awareness; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000628:therapy*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D055502:Secondary Prevention; D055815:Young Adult
D000928:Antidepressive Agents