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-based cognitive therapy (MBCT) added to usual services reduces health anxiety more than usual services alone, with moderate effect sizes immediately after treatment (Cohen's d = 0.48) and at one-year follow-up (d = 0.48). At one year, 36% of MBCT participants still met criteria for hypochondriasis versus 76% of those receiving usual services alone. Improvements in mindfulness mediated the reduction in health anxiety symptoms. The findings suggest MBCT is a useful addition for patients with health anxiety.
Mindfulness-based cognitive therapy (MBCT) is an acceptable and beneficial treatment for severe health anxiety. In interviews three months after completing an MBCT course, most participants reported improvements in both health anxiety and broader functioning. Notably, the practice of focusing attention on bodily sensations did not worsen their health anxiety. Participants described cultivating a new approach to health anxiety and to life in general, though some identified barriers to experiencing change through MBCT.