A Randomized Controlled Pilot Study on Mindfulness-Based Cognitive Therapy for Unipolar Depression in Patients With Chronic Pain.
Study Goal
The researchers aimed to evaluate the effectiveness of mindfulness-based cognitive therapy (MBCT) in treating depression among individuals with chronic pain.
Results Summary
MBCT showed a significant reduction in depressive symptoms (QIDS-C₁₆ scores) in the per-protocol sample but no significant differences in HDRS₁₇ scores between groups. The study was underpowered due to an early termination, potentially limiting effect detection in some outcomes.
Population
Adults with chronic pain (≥3 months) and comorbid depression (MDD, dysthymic disorder, or depressive disorder NOS).
Effective Dosage
8 sessions (participants completed at least 4 sessions in the per-protocol sample).
Duration
Data collection occurred between January 2012 and July 2013; exact intervention duration not specified.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness-based cognitive therapy (MBCT) | decrease | QIDS-C₁₆ score | participants with chronic pain and depressive disorders | F₁,₃₁ = 4.67, P = .039, η²p = 0.13 | revealed a significant treatment × time interaction | #1 |
mindfulness-based cognitive therapy (MBCT) | decrease | QIDS-C₁₆ score | MBCT group (per-protocol sample) | t₁₈ = 5.15, P < .001, d = >1.6 | significant decrease | #2 |
waitlist (control) | no change | QIDS-C₁₆ score | control group | t₁₃ = 2.01, P = .066 | not significant decrease | #3 |
mindfulness-based cognitive therapy (MBCT) | no change | HDRS₁₇ scores | participants with chronic pain and depressive disorders | - | did not differ significantly | #4 |
mindfulness-based cognitive therapy (MBCT) | no change | primary outcome measures (QIDS-C₁₆, HDRS₁₇) | intent-to-treat sample (n = 40) | - | no significant differences | #5 |
mindfulness-based cognitive therapy (MBCT) | decrease | depression | individuals with chronic pain | - | shows potential as a treatment | #6 |
OBJECTIVE: Chronic pain is a disabling illness, often comorbid with depression. We performed a randomized controlled pilot study on mindfulness-based cognitive therapy (MBCT) targeting depression in a chronic pain population. METHOD: Participants with chronic pain lasting ≥ 3 months; DSM-IV major depressive disorder (MDD), dysthymic disorder, or depressive disorder not otherwise specified; and a 16-item Quick Inventory of Depressive Symptomatology-Clinician Rated (QIDS-C₁₆) score ≥ 6 were randomly assigned to MBCT (n = 26) or waitlist (n = 14). We adapted the original MBCT intervention for depression relapse prevention by modifying the psychoeducation and cognitive-behavioral therapy elements to an actively depressed chronic pain population. We analyzed an intent-to-treat (ITT) and a per-protocol sample; the per-protocol sample included participants in the MBCT group who completed at least 4 of 8 sessions. Changes in scores on the QIDS-C₁₆ and 17-item Hamilton Depression Rating Sale (HDRS₁₇) were the primary outcome measures. Pain, quality of life, and anxiety were secondary outcome measures. Data collection took place between January 2012 and July 2013. RESULTS: Nineteen participants (73%) completed the MBCT program. No significant adverse events were reported in either treatment group. ITT analysis (n = 40) revealed no significant differences. Repeated-measures analyses of variance for the per-protocol sample (n = 33) revealed a significant treatment × time interaction (F₁,₃₁ = 4.67, P = .039, η²p = 0.13) for QIDS-C₁₆ score, driven by a significant decrease in the MBCT group (t₁₈ = 5.15, P < .001, d = >1.6), but not in the control group (t₁₃ = 2.01, P = .066). The HDRS₁₇ scores did not differ significantly between groups. The study ended before the projected sample size was obtained, which might have prevented effect detection in some outcome measures. CONCLUSIONS: MBCT shows potential as a treatment for depression in individuals with chronic pain, but larger controlled trials are needed. TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT01473615.