title: Patients with a preference for medication do equally well in mindfulness-based cognitive therapy for recurrent depression as those preferring mindfulness.
abstract: BACKGROUND
  Previous studies have suggested that patients' treatment preferences may influence treatment outcome. The current study investigated whether preference for either mindfulness-based cognitive therapy (MBCT) or maintenance antidepressant medication (mADM) to prevent relapse in recurrent depression was associated with patients' characteristics, treatment adherence, or treatment outcome of MBCT.
  
  
  METHODS
  The data originated from two parallel randomised controlled trials, the first comparing the combination of MBCT and mADM to MBCT in patients preferring MBCT (n=249), the second comparing the combination to mADM alone in patients preferring mADM (n=68). Patients' characteristics were compared across the trials (n=317). Subsequently, adherence and clinical outcomes were compared for patients who all received the combination (n=154).
  
  
  RESULTS
  Patients with a preference for mADM reported more previous depressive episodes and higher levels of mindfulness at baseline. Preference did not affect adherence to either MBCT or mADM. With regard to treatment outcome of MBCT added to mADM, preference was not associated with relapse/recurrence (χ(2)=0.07; p=.80), severity of (residual) depressive symptoms during the 15-month follow-up period (β=-0.08, p=.49), or quality of life.
  
  
  CONCLUSIONS
  The group preferring mADM was relatively small. The influence of preferences on outcome may have been limited in the current study because both preference groups received both interventions.
  
  
  CONCLUSIONS
  The fact that patients with a preference for medication did equally well as those with a preference for mindfulness supports the applicability of MBCT for recurrent depression. Future studies of MBCT should include measures of preferences to increase knowledge in this area.
authors: Department of Psychiatry, Radboud University Medical Centre, Reinier Postlaan 10, 6525 GC Nijmegen, The Netherlands. Electronic address: marloes.huijbers@radboudumc.nl.
authors: Marloes J
authors: MJ
authors: Huijbers
authors: Institute of Psychology, Leiden University, Wassenaarseweg 52, 2333 AK Leiden and Department of Psychiatry, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.
authors: Philip
authors: P
authors: Spinhoven
authors: GGZ InGeest and VU University Medical Center, A.J. Ernststraat 1187, 1081 HL Amsterdam, The Netherlands.
authors: Digna J F
authors: DJ
authors: van Schaik
authors: University of Groningen, University Medical Center Groningen, Department of Psychiatry, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
authors: Willem A
authors: WA
authors: Nolen
authors: Department of Psychiatry, Radboud University Medical Centre, Reinier Postlaan 10, 6525 GC Nijmegen, The Netherlands.
authors: Anne E M
authors: AE
authors: Speckens
mesh_terms: D000328:Adult; D000368:Aged; D000928:Antidepressive Agents / Q000627:therapeutic use; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D057240:Patient Preference; D011788:Quality of Life / Q000523:psychology; D012008:Recurrence; D055502:Secondary Prevention / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000928:Antidepressive Agents
keywords: Antidepressant medication; Depression; Mindfulness-based cognitive therapy; Relapse prevention; Treatment preference