Metta-Based Therapy for Chronic Depression: a Wait List Control Trial

Combining Loving Kindness group meditation with individual therapy focused on kindness toward oneself and others (metta-based therapy, MBT) reduced depressive symptoms more than a wait list control in patients with chronic depression. Forty-eight patients with persistent depressive disorder were randomly assigned to MBT or a wait list. After group meditation and at 6-month follow-up, MBT showed greater improvements in clinician-rated and self-reported depression, behavioral activation, rumination, social functioning, mindfulness, and emotion regulation, with large effect sizes. Most gains occurred during group meditation and were maintained at follow-up. The results provide preliminary support for MBT's effectiveness.

Study at a glance

Abstract

Objectives: Current treatments for chronic depression have focused on reducing interpersonal problems and negative affect, but paid little attention to promoting prosocial motivation and positive affect. Following this treatment focus, the objective of the present study was to examine whether the combination of metta (Loving Kindness) group meditation and subsequent tailored individual therapy focusing on kindness towards oneself and others (metta-based therapy, MBT) shows greater improvements in depressive symptoms than a wait list control group in patients with chronic depression. Methods: Forty-eight patients with DSM-5 persistent depressive disorder were randomly assigned to MBT or a wait list control condition. Outcome was assessed after group meditation, after subsequent individual therapy, and at 6-month follow-up. The primary outcome measure was an independent blind rating of depressive symptoms at post-test. Secondary outcome included changes in self-reported depression, behavioral activation, rumination, social functioning, mindfulness, compassion, and clinician-rated emotion regulation. Results: Mixed-design analyses showed significant differences between MBT and WLC in changes from pre- to post-test in clinician-rated and self-rated depression, behavioral activation, rumination, social functioning, mindfulness, and emotion regulation. Most of the changes occurred during group meditation and were associated with large effect sizes. Improvements were maintained at 6-month follow-up. Conclusions: The results provide preliminary support for the effectiveness of MBT in treating chronic depression. Trial Registration: ISRCTN, ISRCTN97264476.