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Relapse prevention in major depressive disorder: Mindfulness-based cognitive therapy versus an active control condition.

Amanda J Shallcross, James J. Gross, Pallavi Visvanathan, Niketa Kumar, Amy Palfrey, Brett Q Ford, Sona Dimidjian, Stephen Shirk, Jill Holm-Denoma, Kari M Goode, Erica Cox, William Chaplin, Iris B Mauss

Journal of Consulting and Clinical Psychology October 2015 DOI: 10.1037/ccp0000050 (opens in new tab)

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AI-extracted from the abstract
Characteristics Randomized controlled trial Peer reviewed
Sample size 92
Population Adults in remission from major depressive disorder with residual depressive symptoms
Interventions Mindfulness-based cognitive therapy (MBCT) active control condition (ACC)
Duration 8-week intervention, 60-week follow-up
Topics Depression Meditation
Key findings MBCT did not differ from an active control condition in depression relapse rates, time to relapse, depressive symptom reduction, or life satisfaction over 60 weeks. Both groups improved equally, but symptom trajectories differed: the active control group improved immediately postintervention then gradually worsened, while the MBCT group improved gradually and linearly. The authors suggest intervention-specific skills may be associated with different rates of therapeutic benefit.

Abstract

We evaluated the comparative effectiveness of mindfulness-based cognitive therapy (MBCT) versus an active control condition (ACC) for depression relapse prevention, depressive symptom reduction, and improvement in life satisfaction. Ninety-two participants in remission from major depressive disorder with residual depressive symptoms were randomized to either an 8-week MBCT or a validated ACC that is structurally equivalent to MBCT and controls for nonspecific effects (e.g., interaction with a facilitator, perceived social support, treatment outcome expectations). Both interventions were delivered according to their published manuals. Intention-to-treat analyses indicated no differences between MBCT and ACC in depression relapse rates or time to relapse over a 60-week follow-up. Both groups experienced significant and equal reductions in depressive symptoms and improvements in life satisfaction. A significant quadratic interaction (Group × Time) indicated that the pattern of depressive symptom reduction differed between groups. The ACC experienced immediate symptom reduction postintervention and then a gradual increase over the 60-week follow-up. The MBCT group experienced a gradual linear symptom reduction. The pattern for life satisfaction was identical but only marginally significant. MBCT did not differ from an ACC on rates of depression relapse, symptom reduction, or life satisfaction, suggesting that MBCT is no more effective for preventing depression relapse and reducing depressive symptoms than the active components of the ACC. Differences in trajectory of depressive symptom improvement suggest that the intervention-specific skills acquired may be associated with differential rates of therapeutic benefit. This study demonstrates the importance of comparing psychotherapeutic interventions to active control conditions.

Comparable studies

Other randomized controlled trials on depression, most cited first.

Study Year Design Participants
A Randomized Trial of an N-methyl-D-aspartate Antagonist in Treatment-Resistant Major Depression Subjects with DSM-IV major depression (treatment resistant) 2006 Randomized, placebo-controlled, double-blind crossover study n = 18
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety 2016 Randomized controlled trial n = 51
Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Patients with cancer-related anxiety and depression 2016 Double-blind, placebo-controlled, crossover trial n = 29
Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients 2004 Randomized controlled trial n = 73

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Depression Meditation