Adding mindfulness-based cognitive therapy to maintenance antidepressant medication for prevention of relapse/recurrence in major depressive disorder: Randomised controlled trial.
Study Goal
The researchers aimed to determine whether adding mindfulness-based cognitive therapy (MBCT) to maintenance antidepressant medication (mADM) was more effective in preventing depressive relapse than mADM alone.
Results Summary
The study found no significant differences between MBCT+mADM and mADM alone in preventing depressive relapse/recurrence or reducing residual depressive symptoms. Recruitment challenges and patient preferences may have influenced outcomes.
Population
Recurrently depressed patients in remission who had been using mADM for 6 months or longer.
Effective Dosage
Not specified
Duration
15 months (follow-up period)
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mindfulness-based cognitive therapy (MBCT) | decrease | relapse in recurrent depression | recurrently depressed patients | - | reduce the risk of relapse | #1 |
maintenance antidepressant medication (mADM) | decrease | relapse in recurrent depression | recurrently depressed patients | - | reduce the risk of relapse | #2 |
MBCT+mADM | no change | depressive relapse/recurrence within 15 months | recurrently depressed patients in remission who had been using mADM for 6 months or longer | - | no significant differences | #3 |
MBCT+mADM | no change | time to relapse/recurrence | recurrently depressed patients in remission who had been using mADM for 6 months or longer | - | no significant differences | #4 |
MBCT+mADM | no change | depression severity | recurrently depressed patients in remission who had been using mADM for 6 months or longer | - | no significant differences | #5 |
MBCT | no change | risk for relapse/recurrence | recurrently depressed patients in remission and using mADM for 6 months or longer | - | did not further reduce | #6 |
MBCT | no change | (residual) depressive symptoms | recurrently depressed patients in remission and using mADM for 6 months or longer | - | did not further reduce | #7 |
BACKGROUND: Mindfulness-based cognitive therapy (MBCT) and maintenance antidepressant medication (mADM) both reduce the risk of relapse in recurrent depression, but their combination has not been studied. Our aim was to investigate whether the addition of MBCT to mADM is a more effective prevention strategy than mADM alone. METHODS: This study is one of two multicenter randomised trials comparing the combination of MBCT and mADM to either intervention on its own. In the current trial, recurrently depressed patients in remission who had been using mADM for 6 months or longer (n=68), were randomly allocated to either MBCT+mADM (n=33) or mADM alone (n=35). Primary outcome was depressive relapse/recurrence within 15 months. Key secondary outcomes were time to relapse/recurrence and depression severity. Analyses were based on intention-to-treat. RESULTS: There were no significant differences between the groups on any of the outcome measures. LIMITATIONS: The current study included patients who had recovered from depression with mADM and who preferred the certainty of continuing medication to the possibility of participating in MBCT. Lower expectations of mindfulness in the current trial, compared with the parallel trial, may have caused selection bias. In addition, recruitment was hampered by the increasing availability of MBCT in the Netherlands, and even about a quarter of participants included in the trial who were allocated to the control group chose to get MBCT elsewhere. CONCLUSIONS: For this selection of recurrently depressed patients in remission and using mADM for 6 months or longer, MBCT did not further reduce their risk for relapse/recurrence or their (residual) depressive symptoms.