Mindfulness cognitive therapy to prevent depression relapse

January 01, 0001

Mindfulness cognitive therapy to prevent depression relapse

Mindfulness-based cognitive therapy (MBCT) is a group-based psychosocial intervention designed to enhance self-management of prodromal symptoms associated with depressive relapse. These Canadian authors compared rates of relapse in depressed patients in remission receiving MBCT against maintenance antidepressant pharmacotherapy, the current standard of care. Adult patients (n=84) who met remission criteria after 8 months of algorithm- informed antidepressant treatment were randomized to receive maintenance antidepressant medication, MBCT, or placebo and were followed up for 18 months.

They found: "Intention-to-treat analyses showed a significant interaction between the quality of acute-phase remission and subsequent prevention of relapse in randomized patients. Among unstable remitters (1 or more Hamilton Rating Scale for Depression score greater than 7 during remission), patients in both MBCT and maintenance treatment showed a 73% decrease in hazard compared with placebo, whereas for stable remitters (all Hamilton Rating Scale for Depression scores 7 during remission) there were no group differences in survival."

The authors concluded: "For depressed patients achieving stable or unstable clinical remission, MBCT offers protection against relapse/recurrence on a par with that of maintenance antidepressant pharmacotherapy. Our data also highlight the importance of maintaining at least 1 long-term active treatment in unstable remitters."

An option for maintenance therapy without drugs is a helpful addition.

For the full abstract, click here.

Arch Gen Psychiatry 67(12):1256-1264, December 2010
© 2010 to the American Medical Association
Antidepressant Monotherapy vs Sequential Pharmacotherapy and Mindfulness-Based Cognitive Therapy, or Placebo, for Relapse Prophylaxis in Recurrent Depression. Zindel V. Segal, Peter Bieling, Trevor Young, et al. Correspondence to Dr. Segal: [email protected]

Category: P. Psychological. Keywords: mindfulness-based cognitive therapy, depression, remission, relapse, pharmacotherapy, randomized controlled trial, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 4 January 2011

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.