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Evidence Summary

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In people with recurrent depression, mindfulness-based cognitive therapy reduces relapse

Kuyken W, Warren FC, Taylor RS, et al. Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis From Randomized Trials. JAMA Psychiatry. 2016;73:565-74.

Review question

In people who have recovered from recurrent depression, does mindfulness-based cognitive therapy (MBCT) prevent relapse?

Background

Depression is a common mood disorder that affects how you feel, think, and behave. Symptoms include feeling sad, losing interest in things you like to do, having trouble thinking or concentrating, and feeling anxious or restless. It is more than just being sad and may get worse if not treated.

Some people will have only one episode of depression, while others will have more than one episode (recurrent depression). In people who have fully or mostly recovered from an episode of depression, some treatments, such as MBCT, may prevent a new episode (recurrence) or worsening symptoms (relapse).

MBCT is a type of psychological therapy that focuses on meditative practices and helps you manage thinking that may be inaccurate or overly negative.

How the review was done

The review included 9 studies (randomized controlled trials) that were published in English up to November 2014. The trials included 1,258 adults who were, on average, 47 years of age. 75% were women.

People had a doctor’s diagnosis of recurrent depression. They had mostly recovered from their latest episode of depression (full or partial remission) at the start of the trials.

Trials compared MBCT with a control treatment that didn’t include MBCT. In 5 trials the control treatment was usual care or psychological education. In 4 trials, the control treatment was antidepressant drugs.

Trials didn’t report the duration of MBCT.

What the researchers found

People who had MBCT were less likely to have a relapse of depression over 60 weeks than those who had usual care or a different treatment, including antidepressant drugs.

People with more severe depression symptoms before starting MBCT may benefit most.

Conclusion

In people with recurrent depression, mindfulness-based cognitive therapy reduces relapse at 60 weeks more than usual care or another treatment.

Mindfulness-based cognitive therapy (MBCT) vs treatment without MBCT for preventing relapse in people with recurrent depression

Comparisons

Number of trials and people

Rate of relapse with MBCT

Rate of relapse with non-MBCT treatment

Effect of MBCT at  60 weeks

MBCT vs any non-MBCT treatment

9 trials (1,258 people)

38%

49%

About 12 fewer people out of 100 had a relapse of depression (from as few as 7 to as many as 17)

MBCT vs antidepressant drugs

4 trials (637 people)

Not reported

Not reported

Fewer people had a relapse of depression (relative risk reduction 23%, from as little as 2% to as much as 40%)

 




Glossary

Randomized controlled trials
Studies where people are assigned to one of the treatments purely by chance.

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DISCLAIMER These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

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