Follow-up outcomes of Mindfulness-Based Cognitive Therapy (MBCT) for patients with chronic, treatment-resistant depression.

For chronically depressed patients who have not responded to prior treatments, mindfulness-based cognitive therapy (MBCT) produces clinical benefits that persist for at least six months after the program ends. Depressive symptoms, quality of life, rumination, mindfulness skills, and self-compassion all remained stable during follow-up, and remission rates actually increased further. Patients who entered treatment with higher levels of rumination showed greater reductions in depressive symptoms and better quality of life at six months, after accounting for initial symptom severity. Other factors—duration of the current depressive episode, degree of treatment resistance, childhood trauma, and baseline mindfulness or self-compassion—did not predict outcomes.

Study at a glance

Abstract

BACKGROUND Mindfulness-based cognitive therapy (MBCT) is an evidence-based treatment for depression. The current study focused on the long-term effects of MBCT for chronically, treatment-resistant depressed patients during a 6-months follow-up period. Additionally, predictors of treatment outcomes were explored. METHOD The outcomes of MBCT on depressive symptoms, remission rates, quality of life, rumination, mindfulness skills and self-compassion were investigated in a cohort of chronically, treatment-resistant depressed outpatients (N = 106), who had taken part in an RCT comparing MBCT with treatment-as-usual (TAU). Measures were assessed pre-MBCT, post-MBCT, at 3-months follow-up, and at 6-months follow-up. RESULTS Results of linear mixed effect models and Bayesian repeated measures ANOVA's reveal that depressive symptoms, quality of life, rumination, mindfulness skills and self-compassion consolidated during follow-up. Remission rates even further increased over the course of follow-up. When controlling for symptoms at baseline, higher baseline levels of rumination predicted lower depressive symptoms and quality of life at 6-month follow-up. No other predictors (i.e. duration of current depressive episode, level of treatment-resistance, childhood trauma, mindfulness skills, self-compassion) were found. LIMITATIONS All participants received MBCT, therefore time or other non-specific effects might have influenced the results and replication in studies including a control condition is needed. CONCLUSIONS Results indicate that the clinical benefits of MBCT for chronically, treatment-resistant depressed patients persist up to 6 months after completing MBCT. Duration of the current episode, level of treatment-resistance, childhood trauma and baseline levels of mindfulness skills and self-compassion did not predict treatment outcome. When controlling for baseline depressive symptoms participants with high levels of rumination seem to benefit more; however more research is needed. TRIAL REGISTRY Dutch Trial Registry, number NTR4843.