Psychotherapy and Psychosomatics
June 12, 2026
Thorsten Barnhofer, Maria Niemi, Johannes Michalak et al.
1 citation
INTRODUCTION: Around a third of patients with major depressive disorder experience persistent symptoms despite usual treatments. Identifying scalable, psychological treatment options is critical to reduce the burden associated with difficult-to-treat depression (DTD). We examined the efficacy of mindfulness-based cognitive therapy (MBCT) compared with treatment as usual (TAU) and other active...
BMJ Open
April 1, 2026
Maria Niemi, Johannes Michalak, Maria Velana et al.
Introduction Mindfulness-based interventions are widely used, yet concerns about potential negative effects—particularly those related to mindfulness meditation practice—have gained increasing attention. Individuals with difficult-to-treat depression (DTD) represent a population of particular relevance due to heightened vulnerability, but comparative evidence on clinically relevant negative...
BMJ Open
December 8, 2025
Thorsten Barnhofer, Maria Niemi, Johannes Michalak et al.
Introduction: About 30% of depressed patients suffer from a protracted course in which the disorder continues to cause significant burden despite treatment efforts. While originally developed for relapse prevention, mindfulness-based cognitive therapy (MBCT) has increasingly been investigated in depressed patients with such 'difficult-to-treat' courses. This is a protocol for an individual...
medRxiv
June 9, 2025
Thorsten Barnhofer, Maria Niemi, Johannes Michalak et al.
preprint
ABSTRACT: Introduction: About 30% of depressed patients suffer from a protracted course in which the disorder continues to cause significant burden despite treatment efforts. While originally developed for relapse prevention, Mindfulness-Based Cognitive Therapy (MBCT) has increasingly been investigated in depressed patients with such ‘difficult-to-treat’ courses. This is a protocol for an...
Johannes Michalak, Maria Niemi, Maria Velana et al.
preprint
ABSTRACT Background Chronic and treatment-resistant depression remains a challenge. Although research has demonstrated positive effects of Mindfulness-Based Cognitive Therapy (MBCT) and Cognitive Behavioral Analysis System of Psychotherapy (CBASP), their potential negative effects—including deterioration, suicidality, and adverse events—are not well understood. Objectives This protocol outlines...