Mindfulness-based cognitive therapy (MBCT) may be more effective at reducing the risk of depressive relapse compared to current standard treatments with antidepressant drugs. A new meta-analysis, published this month in JAMA Psychiatry, also found that MBCT was increasingly effective in patients with the most severe depression symptoms.
“Mindfulness-based cognitive therapy appears efficacious as a treatment for relapse prevention for those who have recurrent depression and provides an alternative choice to other active treatments,” the researchers, led by Oxford psychiatrist, Willem Kuyken, write.
The researchers carried out a meta-analysis of individual patient-level data from nine published randomized trials, including 1,329 participants, that compared MBCT to usual care or treatment with antidepressants. They found that only 229 of the 596 (38%) participants who received MBCT experienced a relapse within the sixty week follow-up period while 327 of 662 (49%) who received only usual care relapsed over the same period.
“Extending previous work, we found that MBCT reduces the risk of depressive relapse/recurrence compared with the current mainstay approach, maintenance antidepressants,” the researchers write.
“We further showed that there is no support for MBCT having differential effects for patients based on their sex, age, education, or relationship status, suggesting the intervention’s generalizability across these characteristics.”
Participants who entered the study with more severe depression symptoms or who had a greater number of previous depressive episodes were found to be a greater risk for depression relapse during the study period. Interestingly, these same patients who were at the greatest risk of relapse appeared to derive the greatest benefit from the mindfulness-based therapy intervention.
According to the researchers, mindfulness-based cognitive therapy has comparable effects to cognitive therapy and interpersonal therapy but might be ideally suited for “teaching skills to stay well to people currently well but at a high risk of depressive relapse.”
In an accompanying editorial, Richard Davidson connects these results with the basic science studies revealing that mindfulness-based approaches may alter brain function. While the research is new, there is evidence that mindfulness may lead to changes in brain structures associated with attention, emotion, and “self-relevant processing,” or the degree to which individuals interpret events to be related to themselves.
Davidson also points to new research suggesting that the effects of mindfulness may be strengthened when combined with other activities, especially physical and aerobic exercise.
Davidson, R.J., 2016. Mindfulness-Based Cognitive Therapy and the Prevention of Depressive Relapse: Measures, Mechanisms, and Mediators.JAMA psychiatry. (Full Text)
Willem Kuyken et al. Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis from Randomized Trials. JAMA Psychiatry, April 27, 2016 DOI: 10.1001/jamapsychiatry.2016.0076 (Abstract)