Article

Mindfulness-Based Cognitive Therapy to Prevent Relapse in Recurrent Depression

Mood Disorders Centre, University of Exeter, Exeter, Devon, UK.
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 01/2009; 76(6):966-78. DOI: 10.1037/a0013786
Source: PubMed

ABSTRACT

For people at risk of depressive relapse, mindfulness-based cognitive therapy (MBCT) has an additive benefit to usual care (H. F. Coelho, P. H. Canter, & E. Ernst, 2007). This study asked if, among patients with recurrent depression who are treated with antidepressant medication (ADM), MBCT is comparable to treatment with maintenance ADM (m-ADM) in (a) depressive relapse prevention, (b) key secondary outcomes, and (c) cost effectiveness. The study design was a parallel 2-group randomized controlled trial comparing those on m-ADM (N = 62) with those receiving MBCT plus support to taper/discontinue antidepressants (N = 61). Relapse/recurrence rates over 15-month follow-ups in MBCT were 47%, compared with 60% in the m-ADM group (hazard ratio = 0.63; 95% confidence interval: 0.39 to 1.04). MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains. There was no difference in average annual cost between the 2 groups. Rates of ADM usage in the MBCT group was significantly reduced, and 46 patients (75%) completely discontinued their ADM. For patients treated with ADM, MBCT may provide an alternative approach for relapse prevention.

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    • "on or recovery from major depression, observed that participants with a history of fewer than three depressive episodes were less likely to complete the program. This finding is potentially suggestive of differences in participants with early and late onset of depression and their readiness for a mindfulnessbased approach (Ma & Teasdale, 2004).Kuyken et al. (2008)found that MBCT participants with a history of suicide were more likely to drop out of treatment. Moreover, Kuyken et al. reported that in prescreening interviews, individuals declining participation cited an unwillingness to invest the requisite time in the MBCT program and a discomfort with the group format, factors echoing Salmon et a"
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    ABSTRACT: Mindfulness has emerged as an important construct in the mental health field. Although evidence suggests benefits, it also appears that excitement over the clinical applications of mindfulness has largely suspended concentrated efforts to clarify fundamental elements of the construct. This article explores conceptual confusion and contrasts primary mindfulness-based techniques before investigating attrition factors, adverse effects of mindfulness practices, and populations contraindicated for mindfulness-based techniques. Implications for practice are provided.
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    • "( Bockting et al . , 2008 ; Kuyken et al . , 2008 ; Olfson et al . , 2006"
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    • "It's believed that MBCT's putative mechanisms of action include enhanced mindfulness (Kuyken et al. 2010b), improved emotional regulation (Arch and Craske 2006), increased self-compassion and acceptance (Kuyken et al. 2008), reduced rumination (Nolen-Hoeksema and Morrow 1991), and the expanded ability to " decenter " from one's automatic thoughts and dysphoric feelings (Teasdale, et al. 2000). While defined in various ways, mindfulness primarily involves the intentional attention to one's inner or outer environment in the present moment. "
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