Mindfulness-based cognitive therapy for recurrent major depression: A 'best buy' for health care?
Frances Shawyer, Joanne Enticott, Mehmet Özmen, Brett Inder, Graham Meadows
Australian & New Zealand Journal of Psychiatry October 2016 DOI: 10.1177/0004867416642847 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 203 |
| Population | Non-depressed adults with a history of three or more major depressive episodes |
| Interventions | Mindfulness-based cognitive therapy depressive relapse active monitoring |
| Duration | 2 years of follow-up |
| Measures | disability-adjusted life years, International Classification of Diseases 12-month severity of depression disability weight from the Global Burden of Disease 2010 |
| Topics | Depression Meditation |
| Keywords | Randomised controlled trial Cost-effectiveness Health economics Mindfulness-based cognitive therapy |
| Key findings | Mindfulness-based cognitive therapy participants had significantly fewer major depressive episode days over two years than controls (average 31 vs 55 days). From a whole-of-society perspective, the intervention dominated usual care by reducing costs while producing health gains, and the authors conclude it has very good health economic properties. |
Abstract
While mindfulness-based cognitive therapy is effective in reducing depressive relapse/recurrence, relatively little is known about its health economic properties. We describe the health economic properties of mindfulness-based cognitive therapy in relation to its impact on depressive relapse/recurrence over 2 years of follow-up. Non-depressed adults with a history of three or more major depressive episodes were randomised to mindfulness-based cognitive therapy + depressive relapse active monitoring (n = 101) or control (depressive relapse active monitoring alone) (n = 102) and followed up for 2 years. Structured self-report instruments for service use and absenteeism provided cost data items for health economic analyses. Treatment utility, expressed as disability-adjusted life years, was calculated by adjusting the number of days an individual was depressed by the relevant International Classification of Diseases 12-month severity of depression disability weight from the Global Burden of Disease 2010. Intention-to-treat analysis assessed the incremental cost-utility ratios of the interventions across mental health care, all of health-care and whole-of-society perspectives. Per protocol and site of usual care subgroup analyses were also conducted. Probabilistic uncertainty analysis was completed using cost-utility acceptability curves. Mindfulness-based cognitive therapy participants had significantly less major depressive episode days compared to controls, as supported by the differential distributions of major depressive episode days (modelled as Poisson, p < 0.001). Average major depressive episode days were consistently less in the mindfulness-based cognitive therapy group compared to controls, e.g., 31 and 55 days, respectively. From a whole-of-society perspective, analyses of patients receiving usual care from all sectors of the health-care system demonstrated dominance (reduced costs, demonstrable health gains). From a mental health-care perspective, the incremental gain per disability-adjusted life year for mindfulness-based cognitive therapy was AUD83,744 net benefit, with an overall annual cost saving of AUD143,511 for people in specialist care. Mindfulness-based cognitive therapy demonstrated very good health economic properties lending weight to the consideration of mindfulness-based cognitive therapy provision as a good buy within health-care delivery.
Comparable studies
Other randomized controlled trials on depression, most cited first.
Citations in the library
Cited by 8
- Intervenciones psicológicas basadas en mindfulness y sus beneficios: estado actual de la cuestión Clínica y Salud October 10, 2016
- 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
- Effectiveness of mindfulness interventions for depressive symptoms in young people: A systematic review and meta-analysis. Journal of Affective Disorders August 26, 2026
- The Effectiveness and Exploratory Cost-Effectiveness of Regular Meditation for Improving Quality of Life: Protocol for a Prospective Longitudinal Cohort Study. JMIR Research Protocols July 17, 2026
- A cost-utility analysis of mindfulness-based cognitive therapy versus cognitive behavioral therapy for major depressive disorder relapse prevention in primary care. Psychiatry Research February 4, 2026
and 3 more in the library
Cites 7
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Mindfulness-based cognitive therapy for recurrent depression: A translational research study with 2-year follow-up Australian & New Zealand Journal of Psychiatry March 4, 2014
- Effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse or recurrence (PREVENT): a randomised controlled trial The Lancet July 4, 2015
- The DARE study of relapse prevention in depression: design for a phase 1/2 translational randomised controlled trial involving mindfulness-based cognitive therapy and supported self monitoring BMC Psychiatry March 12, 2013
- The effect of mindfulness-based cognitive therapy for prevention of relapse in recurrent major depressive disorder: a systematic review and meta-analysis. Clinical Psychology Review May 15, 2011
and 2 more in the library