This paper describes a planned randomized controlled trial testing whether Mindfulness-Based Cognitive Therapy (MBCT), added to treatment as usual, reduces depression symptoms more than treatment as usual alone in patients who have not responded to at least 12 sessions of high-intensity psychological therapy through England's Increasing Access to Psychological Therapies (IAPT) services. The trial will enroll patients meeting criteria for major depressive disorder, randomizing them to MBCT plus usual care or usual care alone. Assessments occur at baseline, 10 weeks, and 34 weeks post-randomization. The primary outcome is depression symptom reduction at 34 weeks measured by the PHQ-9. Cost-effectiveness will also be evaluated.
Long-term meditators showed greater environmental attitudes but not pro-environmental behavior or sustainable well-being compared to non-meditators. An eight-week Mindfulness-Based Stress Reduction program did not significantly improve pro-environmental behavior, environmental attitudes, or sustainable well-being relative to a waitlist or an active control group. However, participation in either meditation or active control training predicted increases in pro-environmental behavior and sustainable well-being compared to waitlist, though the well-being finding was not robust to multiple imputation. Meditation training may promote pro-environmental behavior and related variables, but the specific training tested does not appear uniquely effective.
For people with a history of recurrent depression, mindfulness-based cognitive therapy combined with support to taper antidepressants is not superior to continuing maintenance antidepressants for preventing relapse over two years. In a randomized trial of 424 adults with three or more prior episodes, the time to relapse did not differ between the two groups. Both treatments were associated with enduring positive outcomes in terms of relapse, residual symptoms, and quality of life. Serious adverse events were rare and similar across groups. The findings suggest that MBCT with tapering support offers a comparable alternative to long-term antidepressant use.