NYAPRS Note: The following comes from NYAPRS board member Cindy Petersen-Dana of the MHA of Westchester.
She writes: “Ameta-analysis published in this month's JAMA Psychiatry has found that people withdepressive symptoms, includingsevere symptoms of depression benefit from mindfulness-based cognitive therapy approaches to treatment. Mindfulness has long been known to have many benefits, but has only recently receivedattention from researchersas a viable treatment for mental health conditions.
There is growing evidence that mindfulness practices may help make positive physical changes in the brain that help people better regulate theiremotions, reduce reactivity and improve attention.
Infact, in the study cited here, researchers found thatpeople with thehighest risk ofrecurrent depression seemed to derive the greatest benefit from mindfulness practices.(See abstract below)
Original Investigation | April 27, 2016
Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse
An Individual Patient Data Meta-analysis From Randomized Trials
Willem Kuyken, PhD1; Fiona C. Warren, PhD2; Rod S. Taylor, PhD2; Ben Whalley, PhD3; Catherine Crane, PhD1; Guido Bondolfi, MD, PhD4; Rachel Hayes, PhD5; Marloes Huijbers, MSc6; Helen Ma, PhD1,7; Susanne Schweizer, PhD8; Zindel Segal, PhD9; Anne Speckens, MD6; John D. Teasdale, PhD8; Kees Van Heeringen, PhD10; Mark Williams, PhD1; Sarah Byford, PhD11; Richard Byng, PhD12; Tim Dalgleish, PhD7,8,13
[+] Author Affiliations
JAMA Psychiatry. Published online April 27, 2016. doi:10.1001/jamapsychiatry.2016.0076
Relapse prevention in recurrent depression is a significant public health problem, and antidepressants are the current first-line treatment approach. Identifying an equally efficacious nonpharmacological intervention would be an important development.
Objective To conduct a meta-analysis on individual patient data to examine the efficacy of mindfulness-based cognitive therapy (MBCT) compared with usual care and other active treatments, including antidepressants, in treating those with recurrent depression.
Data Sources English-language studies published or accepted for publication in peer-reviewed journals identified from EMBASE, PubMed/Medline, PsycINFO, Web of Science, Scopus, and the Cochrane Controlled Trials Register from the first available year to November 22, 2014. Searches were conducted from November 2010 to November 2014.
Study Selection Randomized trials of manualized MBCT for relapse prevention in recurrent depression in full or partial remission that compared MBCT with at least 1 non-MBCT treatment, including usual care.
Data Extraction and Synthesis This was an update to a previous meta-analysis. We screened 2555 new records after removing duplicates. Abstracts were screened for full-text extraction (S.S.) and checked by another researcher (T.D.). There were no disagreements. Of the original 2555 studies, 766 were evaluated against full study inclusion criteria, and we acquired full text for 8. Of these, 4 studies were excluded, and the remaining 4 were combined with the 6 studies identified from the previous meta-analysis, yielding 10 studies for qualitative synthesis. Full patient data were not available for 1 of these studies, resulting in 9 studies with individual patient data, which were included in the quantitative synthesis.
Results Of the 1258 patients included, the mean (SD) age was 47.1 (11.9) years, and 944 (75.0%) were female. A 2-stage random effects approach showed that patients receiving MBCT had a reduced risk of depressive relapse within a 60-week follow-up period compared with those who did not receive MBCT (hazard ratio, 0.69; 95% CI, 0.58-0.82). Furthermore, comparisons with active treatments suggest a reduced risk of depressive relapse within a 60-week follow-up period (hazard ratio, 0.79; 95% CI, 0.64-0.97). Using a 1-stage approach, sociodemographic (ie, age, sex, education, and relationship status) and psychiatric (ie, age at onset and number of previous episodes of depression) variables showed no statistically significant interaction with MBCT treatment. However, there was some evidence to suggest that a greater severity of depressive symptoms prior to treatment was associated with a larger effect of MBCT compared with other treatments.
Conclusions and Relevance Mindfulness-based cognitive therapy appears efficacious as a treatment for relapse prevention for those with recurrent depression, particularly those with more pronounced residual symptoms. Recommendations are made concerning how future trials can address remaining uncertainties and improve the rigor of the field.