Mindfulness-based cognitive therapy (MBCT) plus treatment as usual (TAU) did not significantly reduce the risk of relapse to major depressive disorder over 12 months compared with cognitive psychological education (CPE) plus TAU or TAU alone among people with at least three previous episodes. The hazard ratio for MBCT versus CPE was 0.88, and for MBCT versus TAU was 0.69, both with confidence intervals crossing 1.0. However, severity of childhood trauma influenced relapse risk: each one-standard-deviation increase in trauma severity raised the hazard ratio to 1.26. Among participants with above-average childhood trauma, MBCT offered significant protection compared with TAU (hazard ratio 0.43) and a non-significant advantage over CPE. For those with below-average trauma, no differences between treatments appeared.
The authors clarify methodological points from a prior review of mindfulness-based cognitive therapy (MBCT). They describe the randomization procedures used in two major MBCT trials, show that participants receiving treatment as usual did not worsen, and argue for experimental designs that isolate the active treatment component. Reanalyses using multilevel modeling to correct for intragroup correlations reinforced original findings: among patients with three or more previous depressive episodes, MBCT significantly reduced the risk of a further episode and significantly decreased mean Beck Depression Inventory scores after treatment.
Group-based mindfulness therapy for people with current distressing psychotic experiences is feasible to evaluate in a randomized trial, but the primary analysis found no significant differences between those who received the therapy and those on a waiting list. Secondary analyses combining both groups showed significant improvement in clinical functioning and mindfulness of distressing thoughts and images after training, but not for voices. The study included 22 participants randomly assigned to twice-weekly mindfulness sessions for 5 weeks plus home practice, followed by 5 weeks of home practice, or to a waiting list.