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Factors associated with relapse and recurrence of major depressive disorder in patients starting mindfulness-based cognitive therapy.

Depression and anxiety
February 1, 2022
Jessica M de Klerk-Sluis et al. (7 authors)
Journal ArticleRandomized Controlled TrialResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to investigate the association of cognitive reactivity, rumination, self-compassion, and mindfulness with relapse in remitted MDD patients before initiating MBCT.

Results Summary

Higher cognitive reactivity and lower mindfulness were associated with increased relapse risk, while self-compassion showed no association. Rumination was linked to relapse only in patients discontinuing antidepressant medication.

Population

282 remitted MDD participants with ≥3 depressive episodes, using maintenance antidepressant medication for at least 6 months.

Effective Dosage

Not specified

Duration

Not specified

Interactions

Interaction noted with maintenance antidepressant medication (mADM) for rumination.

Extracted Claims (11)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Mindfulness-based cognitive therapy (MBCT)
decrease
relapse prevention
major depressive disorder (MDD)
-
is effective for
#1
Mindfulness-based cognitive therapy (MBCT)
decrease
cognitive reactivity (CR)
major depressive disorder (MDD)
-
reduces
#2
Mindfulness-based cognitive therapy (MBCT)
decrease
rumination
major depressive disorder (MDD)
-
reduces
#3
Mindfulness-based cognitive therapy (MBCT)
increase
self-compassion
major depressive disorder (MDD)
-
enhances
#4
Mindfulness-based cognitive therapy (MBCT)
increase
mindfulness
major depressive disorder (MDD)
-
enhances
#5
-
neutral
relapse
remitted MDD participants
-
were associated with
#6
-
increase
risk of relapse
remitted MDD participants
-
Higher CR
#7
-
increase
risk of relapse
remitted MDD participants
-
lower mindfulness
#8
-
no change
relapse
remitted MDD participants
-
was not associated with
#9
-
neutral
relapse
patients who discontinued their mADM
-
was associated with
#10
-
no change
relapse
patients who continued mADM
-
effect was absent
#11
Abstract

BACKGROUND: Mindfulness-based cognitive therapy (MBCT) is effective for relapse prevention in major depressive disorder (MDD). It reduces cognitive reactivity (CR) and rumination, and enhances self-compassion and mindfulness. Although rumination and mindfulness after MBCT are associated with relapse, the association of CR, rumination, self-compassion, and mindfulness with relapse before initiation of MBCT has never been investigated. METHODS: Data were drawn from two randomized controlled trials, including a total of 282 remitted MDD participants (≥3 depressive episodes) who had been using maintenance antidepressant medication (mADM) for at least 6 months before baseline. All participants were offered MBCT while either their mADM was maintained or discontinued after MBCT. CR, rumination, self-compassion, and mindfulness were assessed at baseline by self-rated questionnaires and were used in Cox proportional hazards regression models to investigate their association with relapse. RESULTS: CR and mindfulness were associated with relapse, independent of residual symptoms, previous depressive episodes, and mADM-use. Higher CR and lower mindfulness increased the risk of relapse. Self-compassion was not associated with relapse. For rumination, a significant interaction with mADM-use was found. Rumination was associated with relapse in patients who discontinued their mADM, while this effect was absent if patients continued mADM. CONCLUSIONS: These results show that CR, rumination, and mindfulness are associated with relapse in remitted MDD-patients before initiation of MBCT, independent of residual symptoms and previous depressive episodes. This information could improve decisions in treatment planning in remitted individuals with a history of depression.

Medical Subject Headings (MeSH)
Cognitive Behavioral TherapyDepressive Disorder, MajorHumansMindfulnessRecurrenceTreatment Outcome
Study Links
Quality Scores
SafetyNot Assessed
Efficacy85/10
Quality90/10
Citation Metrics
Total Citations9
Citations/Year3.0
Relative Citation Ratio1.57
NIH Percentile66.7%
Research Impact Scores
APT Score0.75
Weight Score2.82
Normalized Score0.72
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