Efficacy of mindfulness-based cognitive therapy in mitigating depressive symptoms and suicidal ideation among institutionalized patients with major depressive disorder: findings from a randomized controlled trial.

An 8-week Mindfulness-Based Cognitive Therapy (MBCT) program added to standard pharmacological care reduced depressive symptoms and suicidal ideation more than standard care alone among 101 institutionalized patients with major depressive disorder in northern Nigeria. At the end of the 8-week intervention, MBCT patients scored an average of 9.4 points lower on the BDI-II depression scale and 5.7 points lower on the BSI suicidal ideation scale than controls. These improvements were still present at a 3-month follow-up, with large effect sizes. The findings suggest MBCT is a promising adjunct for institutionalized patients with MDD in this setting.

Study at a glance

Abstract

Major Depressive Disorder (MDD) represents a significant global health challenge, with elevated risks of suicidal ideation. This study evaluated the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) in mitigating depressive symptoms and suicidal ideation among institutionalized patients with MDD in Nigeria. A randomized controlled trial was conducted with 101 participants (MBCT: n = 50, Control: n = 51) in two psychiatric institutions in northern Nigeria. The 8-week MBCT intervention was compared to standard pharmacological care. Outcomes were assessed at baseline, week 4, week 8 (primary endpoint), and 3-month follow-up using the BDI-II and BSI. The primary analysis used linear mixed-effects models; repeated-measures ANOVA was conducted as a supplementary analysis. MBCT significantly reduced BDI-II scores compared to controls at week 8 (between-group difference: -9.4, 95% CI: -12.0 to -6.8, p < 0.001) and 3-month follow-up (-6.7, 95% CI: -9.5 to -3.9, p < 0.001). Similar reductions were observed in BSI scores at week 8 (-5.7, 95% CI: -7.7 to -3.7, p < 0.001) and follow-up (-3.9, 95% CI: -6.0 to -1.8, p < 0.001). Large effect sizes were observed for both measures (Cohen's d: 0.92-1.38). MBCT demonstrated significant efficacy in reducing depressive symptoms and suicidal ideation among institutionalised Nigerian patients with MDD, with effects maintained at 3-month follow-up. These findings suggest that MBCT is a promising adjunct to standard care for institutionalized patients with MDD in this setting. Larger, multisite trials with active comparators are warranted before broader clinical integration in LMICs is recommended. Pan African Clinical Trial Registry (identifier: PACTR201902545863137).