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Mindfulness-based therapy prevents depression relapse

Mindfulness-based cognitive therapy was effective for relapse prevention among individuals with recurrent depression, particularly those with more prominent residual symptoms.

“Interventions that prevent depressive relapse among people at high risk of recurrent episodes have significant potential to reduce the disease’s burden. Mindfulness-based cognitive therapy, one such intervention, teaches psychological skills that target cognitive mechanisms implicated in depressive relapse to people with a history of depression by combining systematic mindfulness training with elements from cognitive therapy,” Willem Kuyken, PhD, of Warneford Hospital, Prince of Wales International Centre, University of Oxford, England, and colleagues wrote.

As an update to a previous meta-analysis assessing efficacy of mindfulness-based cognitive therapy for prevention of depressive relapse in recurrent depression, researchers identified four additional trials suitable for inclusion, yielding 10 studies for qualitative analysis. Study participants (n = 1,258) had a mean age of 47.1 years, and 75% were female.

Participants who received mindfulness-based cognitive therapy had lower risk for depressive relapse within a 60-week follow-up period, compared with those who did not receive mindfulness-based cognitive therapy (HR = 0.69; 95% CI, 0.58-0.82).

Further, mindfulness-based cognitive therapy was associated with a reduced risk for depressive relapse when compared with active treatments (HR = 0.79; 95% CI, 0.64-0.97).

Sociodemographic and psychiatric variables were not statistically significantly associated with mindfulness-based cognitive therapy. However, there was some evidence that indicated greater depressive symptom severity prior to treatment was associated with a larger effect of mindfulness-based cognitive therapy compared with other treatments.

“The meta-analysis by Kuyken et al provides strong evidence that [mindfulness-based cognitive therapy] is effective in reducing risk of depressive relapse and is particularly effective for patients with higher levels of depressive severity before treatment,” Richard J. Davidson, PhD, of University of Wisconsin, Madison, wrote in an accompanying editorial. “The opportunity now is to examine in more detail which types of patients benefit most from [mindfulness-based cognitive therapy], the mechanisms by which [mindfulness-based cognitive therapy] is producing its beneficial change, and how we can better measure the mediators of therapeutic change.” – by Amanda Oldt

Disclosure: Kuyken reports serving as an investigator on one or more of the original randomized clinical trials that contributed data to the individual patient data and secured grant funding for these trials; serving as director of the Oxford Mindfulness Centre; receiving payments for training workshops and presentations related to mindfulness-based cognitive therapy, which are donated to the Oxford Mindfulness Foundation; serving as an unpaid director of the Mindfulness Network Community Interest Company until 2015; and giving evidence to the UK Mindfulness All Party Parliamentary Group. Davidson reports serving as founder and president of Healthy Minds Innovations, a nonprofit corporation associated with the Center for Healthy Minds at the University of Wisconsin, Madison. Please see the full study for a list of all authors’ relevant financial disclosures.