People who have had one or two episodes of depression could benefit
from Mindfulness-Based Cognitive Therapy (MBCT), according to
published today in the British Journal of
The therapy, which involves eight weekly group
sessions, has been endorsed by the National Institute for Health
and Clinical Excellence (NICE) as an effective treatment for
preventing the relapse of depression – but only for patients who
have had three or more previous episodes of major depression.
In this study, researchers from Maastricht
University Medical Centre, under the lead of Dr Marieke Wichers,
recruited 130 adults living in The Netherlands. Participants had
experienced at least one episode of major depressive disorder and
were still experiencing some residual depressive symptoms, such as
fatigue, anxiety, low mood and insomnia. Of the 130 participants,
71 had had two or fewer previous episodes of depression, and
59 had had three or more episodes.
The participants were randomly allocated to
two groups. One group, comprising 64 people, received eight MBCT
training sessions from experienced trainers. The weekly sessions
included guided meditation, experiential exercises and discussions.
In addition to the weekly group sessions, the participants received
CDs with guided exercises, and were given daily homework exercises
taking 30-60 minutes. The other group, comprising 66 people, were
put on a waiting list for treatment and acted as a control.
The research team found that MBCT
significantly reduced people’s residual depressive symptoms,
thereby improving their quality of life. On average, the MBCT group
experienced a 30-35% reduction in their residual symptoms, compared
to 10% in the control group. Importantly, the researchers found no
evidence that MBCT had a greater effect on people who had had three
or more previous episodes of depression than those who had had only
one or two previous episodes, as was found in previous studies.
First author and study coordinator Dr Nicole
Geschwind, now at the University of Leuven in Belgium, said: "Our
study shows that MBCT is effective in reducing depressive symptoms
also in people with only one or two prior depressive episodes.
Based on this study, we believe that MBCT treatment for residual
depressive symptoms should not be restricted to people with three
or more prior depressive episodes – though replication of our
findings with further research is needed. At the very least, the
current practice of restricting MBCT to patients with three or more
episodes of depression needs urgent re-examination."
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Geschwind N, Peeters F, Huibers M, van Os J and Wichers M. Mindfulness-Based Cognitive Therapy and number of previous depressive episodes. British Journal of Psychiatry, epub ahead of print, 9 August 2012