title: Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition.
abstract: OBJECTIVE
  We evaluated the comparative effectiveness of mindfulness-based cognitive therapy (MBCT) versus an active control condition (ACC) for depression relapse prevention, depressive symptom reduction, and improvement in life satisfaction.
  
  
  METHODS
  Ninety-two participants in remission from major depressive disorder with residual depressive symptoms were randomized to either an 8-week MBCT or a validated ACC that is structurally equivalent to MBCT and controls for nonspecific effects (e.g., interaction with a facilitator, perceived social support, treatment outcome expectations). Both interventions were delivered according to their published manuals.
  
  
  RESULTS
  Intention-to-treat analyses indicated no differences between MBCT and ACC in depression relapse rates or time to relapse over a 60-week follow-up. Both groups experienced significant and equal reductions in depressive symptoms and improvements in life satisfaction. A significant quadratic interaction (Group × Time) indicated that the pattern of depressive symptom reduction differed between groups. The ACC experienced immediate symptom reduction postintervention and then a gradual increase over the 60-week follow-up. The MBCT group experienced a gradual linear symptom reduction. The pattern for life satisfaction was identical but only marginally significant.
  
  
  CONCLUSIONS
  MBCT did not differ from an ACC on rates of depression relapse, symptom reduction, or life satisfaction, suggesting that MBCT is no more effective for preventing depression relapse and reducing depressive symptoms than the active components of the ACC. Differences in trajectory of depressive symptom improvement suggest that the intervention-specific skills acquired may be associated with differential rates of therapeutic benefit. This study demonstrates the importance of comparing psychotherapeutic interventions to active control conditions.
authors.affiliation: Department of Population Health, New York University School of Medicine.
authors.forename: Amanda J
authors.initials: AJ
authors.lastname: Shallcross
authors.affiliation: Department of Psychology, Stanford University.
authors.forename: James J
authors.initials: JJ
authors.lastname: Gross
authors.affiliation: Manhattan Center for Cognitive Behavioral Therapy.
authors.forename: Pallavi D
authors.initials: PD
authors.lastname: Visvanathan
authors.affiliation: Department of Psychology, St. John's University.
authors.forename: Niketa
authors.initials: N
authors.lastname: Kumar
authors.affiliation: Department of Psychology, St. John's University.
authors.forename: Amy
authors.initials: A
authors.lastname: Palfrey
authors.affiliation: Department of Psychology, University of California, Berkeley.
authors.forename: Brett Q
authors.initials: BQ
authors.lastname: Ford
authors.affiliation: Department of Psychology, University of Colorado, Boulder.
authors.forename: Sona
authors.initials: S
authors.lastname: Dimidjian
authors.affiliation: Department of Psychology, University of Denver.
authors.forename: Stephen
authors.initials: S
authors.lastname: Shirk
authors.affiliation: Department of Psychology, University of Denver.
authors.forename: Jill
authors.initials: J
authors.lastname: Holm-Denoma
authors.affiliation: Department of Psychology, University of Denver.
authors.forename: Kari M
authors.initials: KM
authors.lastname: Goode
authors.affiliation: Department of Psychology, University of Denver.
authors.forename: Erica
authors.initials: E
authors.lastname: Cox
authors.affiliation: Department of Psychology, St. John's University.
authors.forename: William
authors.initials: W
authors.lastname: Chaplin
authors.affiliation: Department of Psychology, University of California, Berkeley.
authors.forename: Iris B
authors.initials: IB
authors.lastname: Mauss
mesh_terms: D000328:Adult; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003863:Depression / Q000628:therapy; D003865:Major Depressive Disorder / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D064866:Mindfulness / Q000379:methods*; D010549:Personal Satisfaction; D012008:Recurrence; D055502:Secondary Prevention; D012944:Social Support; D013997:Time Factors; D016896:Treatment Outcome