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Group-based behavioral activation with mindfulness treats depression

Group-behavioral activation with mindfulness was effective in reducing the occurrence of depressive symptoms and major depression in primary care, according to findings recently published in Annals of Family Medicine.

According to researchers, behavioral activation with mindfulness therapy consists of psychoeducation as it pertains to well-being; establishing short- and long-term goals; monitoring one’s own moods and activities to determine the link between the two; scheduling daily activities; ascertaining avoidance to help patients develop greater decision making; and a review of behavior activities and mindfulness practice through meditation and body scans. The process takes place during 2-hour weekly sessions for 8 consecutive weeks.

“Previous research has shown that behavioral activation is effective among people with mild to moderate depression while mindfulness-based interventions have been shown to be particularly effective among people with recurrent depression to prevent relapse,” Samuel Y. S. Wong, MD, of the Prince of Wales Hospital at The Chinese University of Hong Kong, told Healio Family Medicine.

He added that combined behavioral activation and mindfulness to improve well-being of adults outside health care settings has only been looked at in a small-scale study involving 16 patients.

Wong and colleagues recruited 231 patients in Hong Kong aged 18 years and older with major depression for 2 weeks or more, who were experiencing significant changes in appetite, concentration, moods, life satisfaction, self-worth, suicidal thoughts or attempts and sleep. These patients were randomly assigned in a 1:1 ratio to receive group-behavioral activation with mindfulness or usual care of active monitoring and minimal counseling.

Researchers found that after 1 year, the behavioral activation with mindfulness therapy recipients had a “slightly more favorable change” in depressive symptoms levels on the Beck Depression Inventory-II (between-group mean score difference = –3.85; 95% CI, –6.36 to –1.34) vs. usual care recipients. Furthermore, major depressive disorder occurred less in the behavioral activation mindfulness therapy group than in the usual care group (10.8% vs. 26.8%, P = .01).

There was no difference between the groups in the Activity and Circumstances Change Questionnaire, the patients’ self-reported assessment of their respective treatments, the Chinese version of the SF-12, the Sheehan Disability Scale, and the State Trait Anxiety Inventory 30.

“In a world that is constantly changing, and medical, clinical, and drugs are always being updated, we, as family physicians, can be more open-minded regarding newer interventions to help our patients,” Wong said in the interview. “A family physician can encourage their patients to participate in group intervention such as behavioral activation with mindfulness to develop behavioral skills that can help them better cope with life stress.”

He stopped short of recommending behavioral activation with mindfulness as an across the board treatment for depression.

“[However, some physicians] may not want to implement the findings since they may well have valid reasons, and [these professionals] know their patients best and would know the most suitable treatments for their patients.” – by Janel Miller

Disclosure: The authors report no relevant financial disclosures.