The effectiveness of a mindfulness-based cognitive therapy programme for preventing relapse in patients with depression
Kanokwan Wongkhueng, Kedsaraporn Kenbubpha, Palida Phalasak, Thawatchai Phalasak, Plubplung Hasook
Research Square October 11, 2026 preprint DOI: 10.21203/rs.3.rs-10890753/v1 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial |
|---|---|
| Sample size | 94 |
| Population | Thai inpatients with moderate to severe ICD-10 depressive disorder at a psychiatric hospital |
| Duration | Six group sessions of 60–90 minutes over three weeks; assessments before and after the intervention and at three months; readmission recorded within three months of discharge |
| Measures | 9Q, RRS, MAS |
| Topics | Depression Meditation |
| Key findings | Brief, nurse-led, culturally adapted MBCT added clinically meaningful benefit to routine inpatient care, sustained to three months, with larger reductions in depressive symptoms and rumination and greater increases in mindfulness than routine care alone. Minimal-symptom status was reached by 51.1% of MBCT participants versus 2.1% of controls (number needed to treat 2.0). Readmission was less frequent under MBCT (2 of 47 versus 7 of 47) but not significantly so, and the trial was underpowered for readmission. |
Abstract
Abstract Objectives Mindfulness-based cognitive therapy (MBCT) has rarely been tested in non-Western inpatient services or delivered by nurses. This trial evaluated a culturally adapted, nurse-led group MBCT programme for Thai inpatients.
Method: Ninety-four inpatients with moderate to severe ICD-10 depressive disorder at a Thai psychiatric hospital were randomised 1:1 to MBCT plus routine nursing care or routine care alone. The programme comprised six group sessions of 60–90 minutes over three weeks. Depressive symptoms (9Q), rumination (RRS) and mindfulness (MAS) were assessed before and after the intervention and at three months; readmission within three months of discharge was recorded. Sixteen completers took part in two focus groups (content analysis).
Results: The arms were equivalent at baseline. Time × Group interactions favoured MBCT on all three outcomes (all p < .001; partial η² = .13–.40). Both arms improved, but at three months MBCT showed lower depressive symptoms (mean difference 3.49, 95% CI [2.75, 4.23], d = 1.93), lower rumination ( d = 3.34) and higher mindfulness ( d = 2.16). Rumination gains were fully maintained after discharge ( p = 1.000) whereas controls deteriorated; mindfulness eroded partially in both arms. Minimal-symptom status was reached by 51.1% of MBCT participants versus 2.1% of controls ( p < .001), a number needed to treat of 2.0. Readmission was less frequent under MBCT (2 of 47 versus 7 of 47) but not significantly so (Fisher's exact p = .158). Three themes emerged: recognising emotions and automatic thoughts; behavioural change with self-compassion; and stress management for relapse prevention.
Conclusions: Brief, nurse-led, culturally adapted MBCT added clinically meaningful benefit to routine inpatient care, sustained to three months. The trial was underpowered for readmission. Partial erosion of mindfulness gains suggests booster contact may be needed. Preregistration TCTR20250927009, Registration date: September 27, 2025
Comparable studies
Other randomized controlled trials on depression, most cited first.
Citations in the library
Cites 5
- Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology 2000
- Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse JAMA Psychiatry April 28, 2016
- Impact of mindfulness and self-compassion on anxiety and depression: The mediating role of resilience International Journal of Clinical and Health Psychology March 11, 2021
- A systematic review of mechanisms of change in mindfulness-based cognitive therapy in the treatment of recurrent major depressive disorder. Clinical Psychology Review April 1, 2015
- 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