Adverse effects during Mindfulness-Based Cognitive Therapy for bipolar disorder are not rare but are generally not serious or long-lasting. In a randomized trial with 144 patients, 29 reported adverse effects, most frequently in the first three weeks. Seven types of adverse effects were observed: cognitive, perceptual, affective, somatic, conative, sense of self, and social. Higher baseline anxiety increased risk. More than half of patients later viewed the adverse effects as part of a therapeutic process rather than harmful. Influencing factors included predisposing, precipitating, perpetuating, and mitigating elements.
Adding mindfulness-based cognitive therapy (MBCT) to treatment as usual (TAU) for bipolar disorder did not reduce depressive symptoms more than TAU alone at post-treatment or at 15 months follow-up. The 144 participants with bipolar I or II were randomly assigned to MBCT plus TAU or TAU only. At post-treatment, MBCT improved mindfulness skills more than TAU. At follow-up, TAU was more effective than MBCT plus TAU for reducing trait anxiety and improving mindfulness skills and positive mental health. Participants with higher baseline depression and functional impairment benefited more from MBCT plus TAU, suggesting MBCT may help those with moderate to severe depression and impairment.
Adding mindfulness-based cognitive therapy (MBCT) to treatment as usual (TAU) for adults with bipolar disorder is likely cost-effective compared to TAU alone. Over 15 months, total societal costs were €615 lower for the MBCT-plus-TAU group, and healthcare costs differed significantly between groups. A small gain in quality-adjusted life years (QALYs) combined with lower costs (€836 after adjustment) made MBCT-plus-TAU the dominant strategy. The probability that the combination was cost-effective was 65%. Sensitivity analyses confirmed the robustness of these results. The difference in clinical effect was small or negligible, but the intervention still reduced overall costs.
In people with bipolar disorder, negative self-referential processing—how one attributes negative traits to oneself and remembers them—is linked to depressive symptoms. In a randomized trial, 49 participants with bipolar disorder were assigned to mindfulness-based cognitive therapy plus treatment as usual or treatment as usual alone. Those who received MBCT showed a reduction in negative self-referential memory bias over time compared to the control group, while positive and negative self-attributions did not change differently between groups. The findings suggest that MBCT may specifically reduce negative memory bias, which could play a role in preventing or treating depressive symptoms in bipolar disorder.