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Mindfulness-based cognitive therapy for patients with chronic, treatment-resistant depression: A pragmatic randomized controlled trial.

Depression and anxiety
October 1, 2018
Mira B Cladder-Micus et al. (6 authors)
Journal ArticlePragmatic Clinical TrialRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine whether Mindfulness-Based Cognitive Therapy (MBCT) is effective for chronic, treatment-resistant depressed patients when added to treatment-as-usual (TAU).

Results Summary

MBCT + TAU did not significantly reduce depressive symptoms compared to TAU alone, but it showed higher remission rates and improvements in rumination, quality of life, mindfulness skills, and self-compassion. Patients who completed MBCT experienced significant reductions in depressive symptoms.

Population

Chronically depressed outpatients with treatment-resistant depression who had previously received pharmacotherapy (≥4 weeks) and psychological treatment (≥10 sessions).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (7)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Mindfulness-based cognitive therapy (MBCT) + treatment-as-usual (TAU)
no change
depressive symptoms
chronically depressed outpatients who previously received pharmacotherapy (≥4 weeks) and psychological treatment (≥10 sessions)
-3.23 [-6.99 to 0.54], d = 0.35, P = 0.09
did not have significantly fewer
#1
Mindfulness-based cognitive therapy (MBCT) + treatment-as-usual (TAU)
increase
remission rates
chronically depressed outpatients who previously received pharmacotherapy (≥4 weeks) and psychological treatment (≥10 sessions)
-
significantly higher
#2
Mindfulness-based cognitive therapy (MBCT) + treatment-as-usual (TAU)
decrease
rumination
chronic, treatment-resistant depressed patients
-
beneficial effects
#3
Mindfulness-based cognitive therapy (MBCT) + treatment-as-usual (TAU)
increase
quality of life
chronic, treatment-resistant depressed patients
-
beneficial effects
#4
Mindfulness-based cognitive therapy (MBCT) + treatment-as-usual (TAU)
increase
mindfulness skills
chronic, treatment-resistant depressed patients
-
beneficial effects
#5
Mindfulness-based cognitive therapy (MBCT) + treatment-as-usual (TAU)
increase
self-compassion
chronic, treatment-resistant depressed patients
-
beneficial effects
#6
Mindfulness-based cognitive therapy (MBCT)
decrease
depressive symptoms
patients who completed MBCT
-
significant reductions
#7
Abstract

BACKGROUND: Chronic and treatment-resistant depressions pose serious problems in mental health care. Mindfulness-based cognitive therapy (MBCT) is an effective treatment for remitted and currently depressed patients. It is, however, unknown whether MBCT is effective for chronic, treatment-resistant depressed patients. METHOD: A pragmatic, multicenter, randomized-controlled trial was conducted comparing treatment-as-usual (TAU) with MBCT + TAU in 106 chronically depressed outpatients who previously received pharmacotherapy (≥4 weeks) and psychological treatment (≥10 sessions). RESULTS: Based on the intention-to-treat (ITT) analysis, participants in the MBCT + TAU condition did not have significantly fewer depressive symptoms than those in the TAU condition (-3.23 [-6.99 to 0.54], d = 0.35, P = 0.09) at posttreatment. However, compared to TAU, the MBCT + TAU group reported significantly higher remission rates (χ CONCLUSION: Although the ITT analysis did not reveal a significant reduction in depressive symptoms of MBCT + TAU over TAU, MBCT + TAU seems to have beneficial effects for chronic, treatment-resistant depressed patients in terms of remission rates, rumination, quality of life, mindfulness skills, and self-compassion. Additionally, patients who completed MBCT showed significant reductions in depressive symptoms. Reasons for non-completion should be further investigated.

Medical Subject Headings (MeSH)
AdultCognitive Behavioral TherapyDepressionDepressive Disorder, Treatment-ResistantFemaleHumansMaleMiddle AgedMindfulnessOutpatientsQuality of LifeTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality80/10
Citation Metrics
Total Citations66
Citations/Year9.4
Relative Citation Ratio4.30
NIH Percentile91.2%
Research Impact Scores
APT Score0.95
Weight Score2.32
Normalized Score0.62
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