The effectiveness of mindfulness-based cognitive therapy for major depressive disorder: evidence from routine outcome monitoring data
Dirk E. M. Geurts, Felix R. Compen, Marleen H.C.T. van Beek, Anne E. M. Speckens
BJPsych Open March 9, 2023 DOI: 10.1192/bjo.2020.118 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Naturalistic cohort Peer reviewed |
|---|---|
| Sample size | 765 |
| Population | Patients with major depressive disorder (current or in remission) treated at a university hospital out-patient clinic in The Netherlands |
| Intervention | Mindfulness-based cognitive therapy |
| Topics | Depression Meditation |
| Keywords | Depressive disorders Group psychotherapy Outcome studies Out-patient treatment Comorbidity |
| Key findings | Mindfulness-based cognitive therapy significantly reduced depressive symptoms in a real-world clinical setting, with improvements independent of depression recurrence or remission status. |
Abstract
Background: Meta-analyses show efficacy of mindfulness-based cognitive therapy (MBCT) in terms of relapse prevention and depressive symptom reduction in patients with major depressive disorder (MDD). However, most studies have been conducted in controlled research settings.
Aims: We aimed to investigate the effectiveness of MBCT in patients with MDD presenting in real-world clinical practice. Moreover, we assessed whether guideline recommendations for MBCT allocation in regard to recurrence and remission status of MDD hold in clinical practice.
Method: This study assessed a naturalistic cohort of patients with (recurrent) MDD, either current or in remission (n = 765), who received MBCT in a university hospital out-patient clinic in The Netherlands. Outcome measures were self-reported depressive symptoms, worry, mindfulness skills and self-compassion. Predictors were MDD recurrence and remission status, and clinical and sociodemographic variables. Outcome and predictor analyses were conducted with linear regression.
Results: MBCT adherence was high (94%). Patients with a lower level of education had a higher chance of non-adherence. Attending more sessions positively influenced improvement in depressive symptoms. Depressive symptoms significantly reduced from pre- to post-MBCT (Δ mean = 7.7, 95%CI = 7.0–8.5, Cohen's d = 0.75). Improvement of depressive symptoms was independent from MDD recurrence and remission status. Unemployed patients showed less favourable outcomes. Worry, mindfulness skills and self-compassion all significantly improved. These improvements were related to changes in depressive symptoms.
Conclusions: Previous efficacy results in controlled research settings are maintained in clinical practice. Results illustrate that MBCT is effective in routine clinical practice for patients suffering from MDD, irrespective of MDD recurrence and remission status.