Depression relapse prophylaxis with Mindfulness-Based Cognitive Therapy: replication and extension in the Swiss health care system.
BACKGROUND
Mindfulness-Based Cognitive Therapy (MBCT) is a group intervention that integrates elements of Cognitive Behavioural Therapy (CBT) with components of mindfulness training to prevent depressive relapse. The efficacy of MBCT compared to Treatment As Usual (TAU), shown in two randomized controlled trials indicates a significant decrease in 1-year relapse rates for patients with at least three past depressive episodes. The present study is the first independent replication trial comparing MBCT+TAU to TAU alone across both language and culture (Swiss health care system).


METHODS
Sixty unmedicated patients in remission from recurrent depression (>or=3 episodes) were randomly assigned to MBCT+TAU or TAU. Relapse rate and time to relapse were measured over a 60 week observation period. The frequency of mindfulness practices during the study was also evaluated.


RESULTS
Over a 14-month prospective follow-up period, time to relapse was significantly longer with MBCT+TAU than TAU alone (median 204 and 69 days, respectively), although both groups relapsed at similar rates. Analyses of homework adherence revealed that following treatment termination, the frequency of brief and informal mindfulness practice remained unchanged over 14 months, whereas the use of longer formal meditation decreased over time.


CONCLUSIONS
Relapse monitoring was 14months in duration and prospective reporting of mindfulness practice would have yielded more precise frequency estimates compared to the retrospective methods we utilized.


CONCLUSIONS
Further studies are required to determine which patient characteristics, beyond the number of past depressive episodes, may predict differential benefits from this therapeutic approach.
Bondolfi
Guido
G
Department of Psychiatry, Geneva University Hospital, Switzerland. guido.bondolfi@hcuge.ch
Jermann
Françoise
F
der Linden
Martial Van
MV
Gex-Fabry
Marianne
M
Bizzini
Lucio
L
Rouget
Béatrice Weber
BW
Myers-Arrazola
Lusmila
L
Gonzalez
Christiane
C
Segal
Zindel
Z
Aubry
Jean-Michel
JM
Bertschy
Gilles
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D003695:Delivery of Health Care; D003866:Depressive Disorder / Q000517:prevention & control* / Q000523:psychology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D019122:Meditation / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods; D055502:Secondary Prevention; D013557:Switzerland; D016896:Treatment Outcome