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.
Mindfulness training can weaken the link between depressive symptoms and suicidal thinking in patients with a history of suicidal depression. In a randomized trial, previously suicidal patients received mindfulness-based cognitive therapy (MBCT), an active control treatment (cognitive psychoeducation, CPE), or treatment as usual (TAU). After treatment, among patients with minimal to moderate depressive symptoms, suicidal cognitions were significantly related to symptom levels in both control groups but not in the MBCT group. This suggests that mindfulness training helps patients decenter from negative thinking, reducing a key vulnerability for relapse into suicidal depression.
In people with recurrent major depression who received Mindfulness-based Cognitive Therapy, those who practiced formal mindfulness exercises at home on at least three days per week during the seven-week treatment were almost half as likely to relapse over the following year as those who practiced less often. The average daily duration of formal practice was also linked to better outcomes. These associations held even after accounting for how plausible participants found the treatment. No significant link was found between informal mindfulness practice and relapse risk, possibly because informal practice is harder to measure. The findings suggest that regular formal home practice enhances the protective effect of MBCT against depression relapse.