Treatment-resistant depressed patients show a good response to Mindfulness-based Cognitive Therapy

M A Kenny, J M G Williams, M A Kenny, J M G Williams

Abstract

Mindfulness-based Cognitive Therapy (MBCT) is a class-based programme designed for use in the prevention of relapse of major depression. Its aim is to teach participants to disengage from those cognitive processes that may render them vulnerable to future episodes. These same cognitive processes are also known to maintain depression once established, hence a clinical audit was conducted to explore the use of MBCT in patients who were currently actively depressed, and who had not responded fully to standard treatments. The study showed that it was acceptable to these patients and resulted in an improvement in depression scores (pre-post Effect Size=1.04), with a significant proportion of patients returning to normal or near-normal levels of mood.

Figures

Fig. 1
Fig. 1
BDI scores pre and post MBCT.

References

    1. Baer R.A. Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology: Science and Practice. 2003;10:125–143.
    1. Baldwin S.A., Murray D.M., Shadish W.R. Empirically supported treatment or type i errors? Problems with analysis of data from group administered treatment. Journal of Consulting and Clinical Psychology. 2005;73:924–935.
    1. Beautrais A.L., Joyce P.R., Mulder R.T., Fergusson D.M., Deavoll B.J., Nightingale S.K. Prevalence and co-morbidity of mental disorders in persons making serious suicidal attempts: A case control study. American Journal of Psychiatry. 1996;153:1009–1014.
    1. Beck A.T., Rush A.J., Shaw B.F., Emery G. Guilford Press; New York: 1979. Cognitive therapy of depression.
    1. Berti Ceroni G., Neri C., Pezzoli A. Chronicity in major depression. A naturalistic prospective study. Journal of Affective Disorders. 1984;7:123–132.
    1. DeRubeis R.J., Hollon S.D., Amsterdam J.D., Shelton R.C., Young P.R., Salomon R.M. Cognitive therapy vs. medications in the treatment of moderate to severe depression. Archives of General Psychiatry. 2005;62:409–416.
    1. Hayes S.C., Follette V.M., Linehan M.M. Guilford; New York: 2004. Mindfulness and acceptance: Expanding the cognitive–behavioural tradition.
    1. Hollon S.D., DeRubeis R.J., Shelton R.C., Amsterdam J.D., Ronald M., Solomon R.M. Prevention of relapse following cognitive therapy vs. medications in moderate to severe depression. Archives of General Psychiatry. 2005;62:417–422.
    1. Jacobson N.S., Martell C.R., Dimidjian S. Behavioural activation treatment for depression: Returning to contextual roots. Clinical Psychology: Science and Practice. 2001;8:255–270.
    1. Jacobson N.S., Truax P. Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Clinical and Consulting Psychology. 1991;59:12–19.
    1. Judd L.J. The clinical course of unipolar major depressive disorders. Archives of General Psychiatry. 1997;54:989–991.
    1. Kabat-Zinn J. Delta; New York: 1990. Full catastrophe living: The program of the Stress Reduction Clinic at the University of Massachusetts Medical Center.
    1. Keller M.B., Lavori P.W., Lewis C.E., Klerman G.L. Predictors of relapse in major depressive disorder. Journal of the American Medical Association. 1983;250:3299–3304.
    1. Kessler R.C., McGonagle K.A., Zhao S., Nelson C.B., Hughes M., Eshleman S. Lifetime and twelve-month prevalence of DSM-III-R psychiatric disorders in the United States: Results from the National Comorbidity Study. Archives of General Psychiatry. 1994;51:8–19.
    1. Ma S.H., Teasdale J.D. Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Clinical and Consulting Psychology. 2004;72:31–40.
    1. Murray C.L., Lopez A.D. Harvard University Press; Boston: 1998. The global burden of disease: A comprehensive assessment of mortality and disability from disease, injuries and risk factors in 1990 and projected to 2020.
    1. Nolen-Hoeksema S. Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology. 1991;100:569–582.
    1. Nolen-Hoeksema S. The role of rumination in depressive disorders and mixed anxiety/depressive symptoms. Journal of Abnormal Psychology. 2000;109:504–511.
    1. Ost L.G. Natur and Kultur; Stockholm, Sweden: 2006. Kognitiv beteendeterapi inom psykiatrin (CBT in psychiatry)
    1. Powell J., Geddes J., Deeks J., Goldacre M., Hawton K. Suicide in psychiatric patients: Risk factors and their predictive power. British Journal of Psychiatry. 2000;176:266–272.
    1. Ramel W., Goldin P.R., Carmona P.E., McQuaid J.R. The effects of mindfulness meditation on cognitive processes and affect in patients with past depression. Cognitive Therapy and Research. 2004;28:433–455.
    1. Segal Z.V., Gemar M., Williams S. Differential cognitive response to a mood challenge following successful cognitive therapy or pharmacotherapy for unipolar depression. Journal of Abnormal Psychology. 1999;108:3–10.
    1. Segal Z.V., Williams J.M.G., Teasdale J.D. Guilford Press; New York: 2002. Mindfulness-based cognitive therapy for depression—A new approach to preventing relapse.
    1. Teasdale J.D., Segal Z.V., Williams J.M.G. How does cognitive therapy prevent relapse and why should attentional control (mindfulness) training help? Behaviour Research and Therapy. 1995;33:25–39.
    1. Teasdale J.D. Emotional processing, three modes of mind and the prevention of relapse in depression. Behaviour Research and Therapy. 1999;37:S53–S77.
    1. Teasdale J.D., Segal Z.V., Williams J.M.G., Ridgeway V.A., Soulsby J.M., Lau M.A. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Clinical and Consulting Psychology. 2000;68:615–623.
    1. Van Valkenburg C., Akiskal H.S., Puzantian V., Rosenthal T. Anxious depressions: Clinical, family history, and naturalistic outcome—Comparisons with panic and major depressive disorders. Journal of Affective Disorders. 1984;6:67–82.
    1. Watkins E., Moulds M. Positive beliefs about rumination in depression—A replication and extension. Personality and Individual Differences. 2005;39:73–82.
    1. Watkins E., Teasdale J.D. Adaptive and maladaptive self-focus in depression. Journal of Affective Disorders. 2004;82:1–8.
    1. Williams J.M.G., Barnhofer T., Crane C., Beck A.T. Problem solving deteriorates following mood challenge in formerly depressed patients with a history of suicidal ideation. Journal of Abnormal Psychology. 2005;114:421–431.
    1. Williams J.M.G., Crane C., Barnhofer T., van der Does A.J.W., Segal Z.V. Recurrence of suicidal ideation across depressive episodes. Journal of Affective Disorders. 2006;91:189–194.

Source: PubMed

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