The efficacy of mindfulness-based cognitive therapy as a public mental health intervention for adults with mild to moderate depressive symptomatology: a randomized controlled trial

Wendy T M Pots, Peter A M Meulenbeek, Martine M Veehof, Jorinde Klungers, Ernst T Bohlmeijer, Wendy T M Pots, Peter A M Meulenbeek, Martine M Veehof, Jorinde Klungers, Ernst T Bohlmeijer

Abstract

Objective: Although there has been growing evidence for the efficacy of mindfulness-based cognitive therapy (MBCT) for different clinical populations, its effectiveness as a public mental health intervention has not been studied. The present study evaluates a community-based MBCT intervention for adults with mild to moderate depressive symptomatology in a large multi-site, pragmatic randomized controlled trial.

Method: The participants with mild to moderate depressive symptomatology were recruited from the general population and randomized to the MBCT intervention (n = 76) or to a waiting list control group (n = 75). Participants completed measures before and after the intervention. Participants in the experimental condition also completed these measures at a 3-month follow-up.

Results: In the experimental condition significant reductions in depression, anxiety, and experiential avoidance, and improvements in mindfulness and emotional- and psychological mental health were found, compared to the waiting list (effect sizes Cohen's d = 0.31-0.56). These effects were sustained at the 3-month follow-up. The likelihood of a clinically significant change in depressive symptoms was significantly higher for the MBCT group [odds ratio (OR) 3.026, p<0.01 at post-treatment; NNT = 5.10].

Discussion: MBCT as a public mental health intervention for adults with mild to moderate depressive symptoms seems effective and applicable in a natural setting.

Trial registration: Nederlands Trial Register NTR2096.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Participant flow.
Figure 1. Participant flow.
MDE  =  major depressive episode.
Figure 2. Mediation model of psychological flexibility…
Figure 2. Mediation model of psychological flexibility and mindfulness as mediators.
Note. AAQ-II, Acceptance and Action Questionnaire-II; FFMQ, Five Facet Mindfulness Questionnaire; Observe, observing; ActAware, acting with awareness; NonJudge, non-judging of inner experience; NonReact, non-reactivity to inner experience. *P<0.05; **P<0.01; ***P<0.001.

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