Mindfulness-Based Cognitive Therapy for Patients With Depression Decreases the Need for Outpatient Visits.
OBJECTIVE
To determine if the use of mindfulness-based cognitive therapy (MBCT) in patients with a history of 2 or more episodes of major depressive disorder and other mood disorders will decrease the need for medication management and other interventions and will also decrease the need for outpatient services and the overall cost of treatment.


METHODS
The study patients completed MBCT group sessions between January 1, 2010, and December 31, 2013. Patients who had 2 or more episodes of major depressive disorder (recurrent MDD) were categorized into a group. The remaining patients with other mood disorders were placed in a comparison group. The mean differences in drug treatments and hospital utilizations between the recurrent MDD and nonrecurrent MDD group were compared. Wald P values and 95% CIs were obtained for both adjusted and unadjusted estimated mean differences. Covariates were adjusted for age at start of MBCT, gender, and race/ethnicity.


RESULTS
The final sample consisted of 142 patients (93 recurrent MDD and 49 others). There was no significant difference in the effect of MBCT on medication changes between recurrent MDD patients and nonrecurrent MDD patients. Recurrent MDD patients who participated in MBCT experienced reduction in all calls and visits (P = .0068) and less psychiatric visits (P = .0026) in the year after MBCT when compared with the visits before the intervention.


CONCLUSIONS
This study evaluated the effectiveness of MBCT in reducing the need for additional psychiatric services. The study evaluated patients who received MBCT over 3 years and demonstrated that MBCT decreased the need for care regardless of medication changes. The results raise the question of whether MBCT allows patients to respond to situations more skillfully or if MBCT itself decreases depressive symptoms. The limitations of this study include a small sample size, patient selection, and its design as a retrospective study. However, this study may have implications as a treatment strategy that may be generalizable to other clinics and patient populations.
University of California Irvine, 101 City Drive, Orange, CA. rbota@uci.edu.|Department of Psychiatry, University of California Irvine, Orange, California, USA.
Robert G
RG
Bota
Kaiser Permanente, Riverside, California, USA.
Jessica
J
Hazen
Regional Research Statistical Support, Kaiser Permanente Southern California, Pasadena, California, USA.
Ryan
R
Tieu
Department of Psychiatry, University of California Irvine, Orange, California, USA.
Andrei
A
Novac
D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003865:Major Depressive Disorder / Q000188:drug therapy / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064866:Mindfulness; D019964:Mood Disorders / Q000188:drug therapy / Q000628:therapy; D055502:Secondary Prevention / Q000379:methods; D016896:Treatment Outcome