Mindfulness-based cognitive therapy to prevent relapse in recurrent depression.
Willem Kuyken1, Sarah Byford, Rod S Taylor
1Mood Disorders Centre, University of Exeter, Exeter, Devon, UK. w.kuyken@exeter.ac.uk
Journal of Consulting and Clinical Psychology
|December 3, 2008
Summary
Mindfulness-based cognitive therapy (MBCT) may be an effective alternative to maintenance antidepressant medication (m-ADM) for preventing depressive relapse. MBCT also improved residual symptoms and quality of life.
Area of Science:
- Psychiatry
- Clinical Psychology
- Health Economics
Background:
- Recurrent depression poses a significant challenge, with relapse rates remaining high even with antidepressant medication (ADM).
- Mindfulness-Based Cognitive Therapy (MBCT) has demonstrated additive benefits in preventing depressive relapse for at-risk individuals.
- The comparative effectiveness and cost-effectiveness of MBCT versus maintenance ADM (m-ADM) in patients with recurrent depression require further investigation.
Purpose of the Study:
- To compare the efficacy of MBCT with m-ADM in preventing depressive relapse in patients with recurrent depression.
- To evaluate secondary outcomes, including residual depressive symptoms, psychiatric comorbidity, and quality of life.
- To assess the cost-effectiveness of MBCT compared to m-ADM.
Main Methods:
- A parallel 2-group randomized controlled trial was conducted.
- 62 patients received m-ADM, while 61 patients received MBCT with support to taper/discontinue ADM.
- Follow-up assessments were conducted over 15 months.
Main Results:
- Relapse/recurrence rates were 47% in the MBCT group versus 60% in the m-ADM group (hazard ratio = 0.63).
- MBCT demonstrated superior outcomes in reducing residual depressive symptoms and psychiatric comorbidity.
- MBCT significantly improved quality of life in physical and psychological domains, with no difference in average annual cost.
- ADM usage was significantly reduced in the MBCT group, with 75% discontinuing medication.
Conclusions:
- MBCT may serve as a viable alternative to m-ADM for relapse prevention in patients with recurrent depression.
- MBCT offers advantages over m-ADM in managing residual symptoms and enhancing overall quality of life.
- The findings suggest MBCT is a cost-effective intervention for recurrent depression, facilitating ADM discontinuation.
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