Putting mindfulness-based cognitive therapy to the test in routine clinical practice: A transdiagnostic panacea or a disorder specific intervention?
Dirk E. M. Geurts, N Marlou Haegens, Marleen H.C.T. van Beek, Maya J. Schroevers, Felix R. Compen, Anne E. M. Speckens
Journal of Psychiatric Research October 2021 DOI: 10.1016/j.jpsychires.2021.07.043 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Randomized Peer reviewed |
|---|---|
| Sample size | 998 |
| Population | Heterogeneous outpatient psychiatric population formally diagnosed mainly with depression, anxiety disorders, personality disorders, somatoform disorders and/or ADHD in routine clinical practice |
| Intervention | Mindfulness-based cognitive therapy (MBCT) |
| Measures | Outcome Questionnaire, reliable change indices |
| Topics | Meditation |
| Keywords | Effectiveness Functioning Psychiatric disorders |
| Key findings | MBCT was associated with improved overall functioning in a large heterogeneous psychiatric outpatient sample, with a moderate effect size (Cohen's d = 0.50) and improvement within each diagnostic category (d = 0.37–0.61), independent of diagnosis or comorbidity. Adherence was high (94%) but lower with less education, more comorbidity, and ADHD; worse baseline functioning predicted larger improvement. |
Abstract
Over the past two decades there has been a growing number of randomized clinical trials supporting the efficacy of mindfulness-based cognitive therapy (MBCT) in the treatment of several psychiatric disorders. Since evidence for its effectiveness in routine clinical practice is lagging behind, we aimed to examine adherence, outcome and predictors of MBCT in a well-characterized, heterogeneous outpatient population in routine clinical practice. Data were collected from a naturalistic uncontrolled cohort of 998 patients formally diagnosed with mainly depression, anxiety disorders, personality disorders, somatoform disorders and/or ADHD. Patients received protocolized MBCT and completed self-report questionnaires pre- and post-treatment on overall functioning (Outcome Questionnaire, primary outcome), depressive symptoms, worry, mindfulness skills and self-compassion. Pre-to post-treatment changes were analysed for the overall sample and each diagnostic category separately with paired sample t-tests, reliable change indices (only overall sample) and repeated measures ANOVA for groups with and without comorbidity. Multiple linear regression was carried out to assess possible predictors of adherence and change in overall functioning. Adherence was high (94%) but negatively affected by lower levels of education, more comorbidity and presence of ADHD. Outcome in terms of improvement in overall functioning was good in the overall sample (Cohen's d = 0.50, 30% showed reliable improvement vs. 3.5% reliable deterioration) and within each diagnostic category (Cohen's d range = 0.37-0.61). Worse overall functioning at baseline was the only predictor for a larger treatment effect. After MBCT, overall functioning improved in a large heterogeneous psychiatric outpatient population independent of diagnosis or comorbidity.
Comparable studies
Other observational and cohort studies on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Using Self-Report Assessment Methods to Explore Facets of Mindfulness Undergraduate students | 2006 | Observational cohort | |
| Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders Patients with generalized anxiety disorder or panic disorder with or without agoraphobia | 1992 | Observational cohort | n = 22 |
| Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls | 2005 | Observational cohort | n = 20 |
| Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls | 2011 | Observational cohort | |
| Long-term meditators self-induce high-amplitude gamma synchrony during mental practice Long-term Buddhist practitioners and controls | 2004 | Observational cohort |
Citations in the library
Cited by 16
- The (In)flexible self: Psychopathology, mindfulness, and neuroscience. International journal of clinical and health psychology : IJCHP 2023
- Mindfulness-Based Cognitive Therapy in Clinical Practice: A Systematic Review of Neurocognitive Outcomes and Applications for Mental Health and Well-Being. Journal of Clinical Medicine March 3, 2025
- Mindfulness-Based Interventions for People with Autism Spectrum Disorder: A Systematic Literature Review. Brain Sciences September 30, 2024
- Cognitive Behavioral Therapy and Mindfulness-Based Cognitive Therapy for Depressive Disorders: Enhancing Access and Tailoring Interventions in Diverse Settings. Advances in experimental medicine and biology 2024
- Mindfulness-based cognitive therapy neurobiology in treatment-resistant obsessive-compulsive disorder: A domain-related resting-state networks approach. European Neuropsychopharmacology May 1, 2024
and 11 more in the library
Cites 19
- Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse JAMA Psychiatry April 28, 2016
- Prospects for a clinical science of mindfulness-based intervention. American Psychologist October 1, 2015
- A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression Psychotherapy and Psychosomatics 2016
- Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: a meta-analysis Cognitive Behaviour Therapy February 8, 2019
- Mindfulness-Based Interventions in Psychiatry. FOCUS: The Journal of Lifelong Learning in Psychiatry January 24, 2018
and 14 more in the library