For people with recurrent depression, mindfulness-based cognitive therapy (MBCT) reduces the risk of depressive relapse within a 60-week follow-up period compared with usual care or other active treatments, including antidepressants. A meta-analysis of individual patient data from 9 randomized trials involving 1258 patients (mean age 47.1 years, 75% female) found that those receiving MBCT had a 31% lower risk of relapse versus no MBCT (hazard ratio 0.69), and a 21% lower risk versus other active treatments (hazard ratio 0.79). Sociodemographic and psychiatric variables did not significantly modify the treatment effect, but greater severity of depressive symptoms before treatment was associated with a larger benefit from MBCT.
Three weekly infusions of ketamine (0.8 mg/kg) helped people with severe alcohol use disorder stay abstinent more days over six months than placebo infusions did. The ketamine group averaged 10.1% more days abstinent than the placebo group. Combining ketamine with mindfulness-based relapse prevention therapy produced the largest improvement, with 15.9% more abstinent days compared with placebo plus alcohol education. No serious adverse events occurred. Relapse rates did not differ significantly between ketamine and placebo groups. The findings suggest ketamine is safe and may support abstinence, especially when paired with psychological therapy.
About half of patients with depression who complete the UK National Health Service Talking Therapies stepped care pathway still have symptoms. A randomized trial tested whether adding mindfulness-based cognitive therapy (MBCT) via videoconference to treatment as usual improves outcomes for these patients. At 34 weeks, the MBCT group had significantly lower depression scores than the treatment-as-usual group (adjusted difference -2.49 points on the PHQ-9). The MBCT group also had slightly lower healthcare costs and higher quality-of-life scores, with a 99% chance of being cost-effective at the £20,000 per QALY threshold. No serious adverse events occurred. MBCT is an effective and scalable further-line treatment for depression that does not remit after psychological therapy.