title: A Preliminary Study: Efficacy of Mindfulness-Based Cognitive Therapy versus Sertraline as First-line Treatments for Major Depressive Disorder.
abstract: Major depressive disorder (MDD) is the leading cause of disability in the developed world, yet broadly effective treatments remain elusive. The primary aim of this pilot study was to investigate the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) monotherapy, compared to sertraline monotherapy, for patients with acute MDD. This open-label, nonrandomized controlled trial examined a MBCT cohort (N=23) recruited to match the gender, age, and depression severity of a depressed control group (N=20) that completed 8 weeks of monotherapy with the antidepressant sertraline. The 17-item clinician-rated Hamilton Depression Severity Rating Scale (HAMD-17) was the primary outcome measure of depression to assess overall change after 8 weeks and rates of response and remission. The 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) was the secondary outcome measure to further assess depression severity. Both cohorts were demographically similar and showed significant improvement in depression ratings. No difference was found in the degree of change in HAMD-17 scores (t(34) = 1.42, p = .165) between groups. Secondary analysis showed statistically significant differences in mean scores of the QIDS-SR16 (t (32) = 4.39, p < 0.0001), with the MCBT group showing greater mean improvement. This study was limited by the small sample size and non-randomized, non-blinded design. Preliminary findings suggest that an 8-week course of MBCT monotherapy may be effective in treating MDD and a viable alternative to antidepressant medication. Greater changes in the self-rated QIDS-SR16 for the MBCT cohort raise the possibility that patients derive additional subjective benefit from enhanced self-efficacy skills.
authors.affiliation: Department of Psychiatry, University of California-San Francisco, Box 0984-AIP, San Francisco, CA 94143. phone: (415) 476-7868; fax: (415) 476-7449.
authors.forename: Stuart J
authors.initials: SJ
authors.lastname: Eisendrath
authors.affiliation: Department of Psychiatry, University of California-San Francisco, Box 0984-AIP, San Francisco, CA 94143.
authors.forename: Erin
authors.initials: E
authors.lastname: Gillung
authors.affiliation: Department of Psychiatry, University of California-San Francisco, Box 0984-AIP, San Francisco, CA 94143.
authors.forename: Kevin
authors.initials: K
authors.lastname: Delucchi
authors.affiliation: San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA 94121.
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Mathalon
authors.affiliation: Department of Psychiatry, University of California-San Francisco, Box 0984-AIP, San Francisco, CA 94143.
authors.forename: Tony T
authors.initials: TT
authors.lastname: Yang
authors.affiliation: Department of Psychiatry, University of California-San Francisco, Box 0984-AIP, San Francisco, CA 94143. Division of Research, Kaiser Permanente, 200 Broadway Blvd, Oakland, CA 94612.
authors.forename: Derek D
authors.initials: DD
authors.lastname: Satre
authors.affiliation: Department of Psychiatry, University of California-San Francisco, Box 0984-AIP, San Francisco, CA 94143.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Rosser
authors.affiliation: Department of Psychiatry, University of California-San Francisco, Box 0984-AIP, San Francisco, CA 94143.
authors.forename: Walter E B
authors.initials: WE
authors.lastname: Sipe
authors.affiliation: Department of Psychiatry, University of California-San Francisco, Box 0984-AIP, San Francisco, CA 94143.
authors.forename: Owen M
authors.initials: OM
authors.lastname: Wolkowitz
keywords: antidepressants; cognitive therapy; major depressive disorder; meditation; mindfulness; sertraline