A Randomized Controlled Pilot Study on Mindfulness-Based Cognitive Therapy for Unipolar Depression in Patients With Chronic Pain.
Marasha De Jong, Frenk Peeters, Tim Gard, Heidi Ashih, Jim Doorley, Rosemary Walker, Laurie Rhoades, Ronald J Kulich, Karsten D Kueppenbender, Jonathan E. Alpert, Elizabeth A Hoge, Willoughby B. Britton, Sara W. Lazar, Maurizio Fava, David Mischoulon
The Journal of Clinical Psychiatry 2018 DOI: 10.4088/jcp.15m10160 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled pilot study Peer reviewed |
|---|---|
| Sample size | 40 |
| Population | Adults with chronic pain lasting at least 3 months and a DSM-IV depressive disorder (major depressive disorder, dysthymic disorder, or depressive disorder not otherwise specified) with a QIDS-C16 score of 6 or higher |
| Intervention | Mindfulness-based cognitive therapy (MBCT) |
| Duration | 8 sessions; data collection January 2012 to July 2013 |
| Measures | 16-item Quick Inventory of Depressive Symptomatology-Clinician Rated (QIDS-C16), 17-item Hamilton Depression Rating Scale (HDRS17) |
| Topics | Depression Meditation |
| Registration | NCT01473615 |
| Key points | In the intention-to-treat sample, MBCT did not significantly differ from waitlist on depression outcomes. In the per-protocol sample of 33 participants, MBCT produced a significant treatment-by-time interaction on QIDS-C16 depression scores, with a large decrease in the MBCT group but not the control group; Hamilton Depression Rating Scale scores did not differ significantly between groups. The authors conclude MBCT shows potential for treating depression in chronic pain, but larger controlled trials are needed. |
Abstract
Chronic pain is a disabling illness, often comorbid with depression. We performed a randomized controlled pilot study on mindfulness-based cognitive therapy (MBCT) targeting depression in a chronic pain population. Participants with chronic pain lasting ≥ 3 months; DSM-IV major depressive disorder (MDD), dysthymic disorder, or depressive disorder not otherwise specified; and a 16-item Quick Inventory of Depressive Symptomatology-Clinician Rated (QIDS-C₁₆) score ≥ 6 were randomly assigned to MBCT (n = 26) or waitlist (n = 14). We adapted the original MBCT intervention for depression relapse prevention by modifying the psychoeducation and cognitive-behavioral therapy elements to an actively depressed chronic pain population. We analyzed an intent-to-treat (ITT) and a per-protocol sample; the per-protocol sample included participants in the MBCT group who completed at least 4 of 8 sessions. Changes in scores on the QIDS-C₁₆ and 17-item Hamilton Depression Rating Sale (HDRS₁₇) were the primary outcome measures. Pain, quality of life, and anxiety were secondary outcome measures. Data collection took place between January 2012 and July 2013. Nineteen participants (73%) completed the MBCT program. No significant adverse events were reported in either treatment group. ITT analysis (n = 40) revealed no significant differences. Repeated-measures analyses of variance for the per-protocol sample (n = 33) revealed a significant treatment × time interaction (F₁,₃₁ = 4.67, P = .039, η²p = 0.13) for QIDS-C₁₆ score, driven by a significant decrease in the MBCT group (t₁₈ = 5.15, P < .001, d = >1.6), but not in the control group (t₁₃ = 2.01, P = .066). The HDRS₁₇ scores did not differ significantly between groups. The study ended before the projected sample size was obtained, which might have prevented effect detection in some outcome measures. MBCT shows potential as a treatment for depression in individuals with chronic pain, but larger controlled trials are needed. ClinicalTrials.gov identifier: NCT01473615.
Comparable studies
Other randomized controlled trials on depression, most cited first.
Citations in the library
Cited by 9
- Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression Frontiers in Psychology June 30, 2016
- Patients with Chronic Pain: Are Mindfulness Traits Protective Against Distress, Anxiety and Depression? Clinical neuropsychiatry October 1, 2023
- Between mood and matter 2018
- Effect of virtual reality-integrated mindfulness-based cognitive therapy on pain and psychological symptoms in chronic non-specific low back pain: protocol for a randomized controlled trial. Frontiers in Digital Health July 31, 2026
- Psychological Therapy in Chronic Pain: Differential Efficacy between Mindfulness-Based Cognitive Therapy and Cognitive Behavioral Therapy Journal of Clinical Medicine August 1, 2021
and 4 more in the library
Cites 16
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- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Journal of Consulting and Clinical Psychology 2004
- Mindfulness-based cognitive therapy as a treatment for chronic depression: A preliminary study Behaviour Research and Therapy February 13, 2009
and 11 more in the library