A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression
Stuart J. Eisendrath, Erin P Gillung, Kevin L. Delucchi, Zindel V. Segal, J. Craig Nelson, L. Alison Mcinnes, Daniel H. Mathalon, Mitchell D. Feldman
Psychotherapy and Psychosomatics 2016 DOI: 10.1159/000442260 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 173 |
| Population | Outpatient adults with treatment-resistant depression |
| Interventions | Mindfulness-based cognitive therapy Health Enhancement Program |
| Duration | 8-week intervention |
| Topics | Anxiety Depression Meditation |
| Keywords | Mindfulness-based cognitive therapy Randomized controlled trial Depression economics Pharmacotherapy Adverse effect Clinical psychology Mood |
| Citations | 193 |
| Key findings | MBCT plus pharmacotherapy led to a significantly greater reduction in depression severity and a higher treatment response rate than an active comparison condition plus pharmacotherapy, but remission rates did not differ significantly. |
Abstract
Background: Due to the clinical challenges of treatment-resistant depression (TRD), we evaluated the efficacy of mindfulness-based cognitive therapy (MBCT) relative to a structurally equivalent active comparison condition as adjuncts to treatment-as-usual (TAU) pharmacotherapy in TRD.
Methods: This single-site, randomized controlled trial compared 8-week courses of MBCT and the Health Enhancement Program (HEP), comprising physical fitness, music therapy and nutritional education, as adjuncts to TAU pharmacotherapy for outpatient adults with TRD. The primary outcome was change in depression severity, measured by percent reduction in the total score on the 17-item Hamilton Depression Rating Scale (HAM-D17), with secondary depression indicators of treatment response and remission.
Results: We enrolled 173 adults; mean length of a current depressive episode was 6.8 years (SD = 8.9). At the end of 8 weeks of treatment, a multivariate analysis showed that relative to the HEP condition, the MBCT condition was associated with a significantly greater mean percent reduction in the HAM-D17 (36.6 vs. 25.3%; p = 0.01) and a significantly higher rate of treatment responders (30.3 vs. 15.3%; p = 0.03). Although numerically superior for MBCT than for HEP, the rates of remission did not significantly differ between treatments (22.4 vs. 13.9%; p = 0.15). In these models, state anxiety, perceived stress and the presence of personality disorder had adverse effects on outcomes.
Conclusions: MBCT significantly decreased depression severity and improved treatment response rates at 8 weeks but not remission rates. MBCT appears to be a viable adjunct in the management of TRD.