title: Expanding the efficacy of Project UPLIFT: Distance delivery of mindfulness-based depression prevention to people with epilepsy.
abstract: OBJECTIVE
  Depression affects about 16% of the U.S. population over a lifetime. People with chronic diseases have especially high rates of comorbid depression; 32% to 48% of people with epilepsy experience depression. This study evaluated the efficacy of a mindfulness-based cognitive therapy intervention for preventing major depressive disorder (MDD) episodes in people with epilepsy.
  
  
  METHODS
  Participants (n = 128) were adults from Georgia, Michigan, Texas, and Washington with epilepsy and mild/moderate depressive symptoms. The 8-session weekly Project UPLIFT intervention, based on mindfulness-based cognitive therapy, was group-delivered via Web or telephone. Using a randomized, controlled crossover design, participants were assigned to Project UPLIFT or a treatment-as-usual (TAU) waitlist and assessed at baseline, and after intervening in the intervention group (∼10 weeks) and in the TAU group (∼20 weeks). Assessments included valid self-report measures of depression and MDD, knowledge/skills, and satisfaction with life.
  
  
  RESULTS
  The incidence of MDD episodes (new or relapse) from baseline to interim assessment was significantly lower in the intervention condition (0.0%) than in TAU (10.7%). Depressive symptoms decreased significantly more in the intervention condition than in TAU; Web and telephone did not differ. Change in knowledge/skills mediated the effect, which persisted over the 10 weeks of follow-up. Knowledge/skills and life satisfaction increased significantly more in the intervention condition than in TAU.
  
  
  CONCLUSIONS
  Distance delivery of group mindfulness-based cognitive therapy can prevent episodes of MDD, reduce symptoms of depression, and increase life satisfaction in people with epilepsy. This intervention is easily modified for persons with other chronic diseases and other disparity populations. (PsycINFO Database Record
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University.
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Thompson
authors.affiliation: Department of Behavioral Sciences and Health Education, Emory University.
authors.forename: Archna H
authors.initials: AH
authors.lastname: Patel
authors.affiliation: Department of Neurology, University of Michigan.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Selwa
authors.affiliation: Center for Managing Chronic Disease, University of Michigan.
authors.forename: Shelley C
authors.initials: SC
authors.lastname: Stoll
authors.affiliation: Center for Health Services Research, University of Texas.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Begley
authors.affiliation: Department of Neurology, Vocational Services Unit, University of Washington.
authors.forename: Erica K
authors.initials: EK
authors.lastname: Johnson
authors.affiliation: Department of Neurology, Vocational Services Unit, University of Washington.
authors.forename: Robert T
authors.initials: RT
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000368:Aged; D015928:Cognitive Behavioral Therapy; D018592:Cross-Over Studies; D003863:Depression / Q000150:complications / Q000517:prevention & control* / Q000523:psychology; D003865:Major Depressive Disorder / Q000150:complications / Q000517:prevention & control* / Q000523:psychology; D004827:Epilepsy / Q000150:complications / Q000523:psychology*; D005260:Female; D005845:Georgia; D006801:Humans; D008297:Male; D019122:Meditation; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D010549:Personal Satisfaction; D011615:Psychotherapy, Group; D019114:Remote Consultation; D057566:Self Report; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult