EFFECTIVENESS OF MINDFULNESS BASED COGNITIVE THERAPY IN REDUCING RELAPSE RATES IN RECURRENT DEPRESSION
Main Article Content
Keywords
Mindfulness-Based Cognitive Therapy, Depressive Disorder, Major, Recurrence, Relapse
Abstract
Background: Chronic depression remains a complex clinical problem, with a high risk of relapse despite maintenance pharmacotherapy. Mindfulness-Based Cognitive Therapy (MBCT) maladaptive thinking and reduce the risk of relapse. Clinical trials indicate that MBCT is associated with decreased relapse, increased resilience and improved coping in RJMDD.
Objectives: The purpose of this study was to investigate the outcome of MBCT for relapse prevention in patients with recurrent depression as compared with treatment-as-usual, in terms of relapse rates and symptom severity, functional outcomes and predictors.
Study Design: A prospective study.
Place and duration of study: Department of psychiatry Nowshera Medical College One Year from Jan 2024 to july 2024
Methods: this prospective study was carried out as a prospective study in 100 patients with remission from recurrent depression. Participants were assigned to one of the two conditions: MBCT intervention or treatment‐as‐usual. The MBCT group underwent an 8-week standardized intervention and controls-maintained treatment as usual. Relapse rate at 12 months was the main outcome, using structured clinical interviews. Secondary end points were depressive symptom scores, quality of life and treatment adherence. SPSS version 24.0 was used for statistical analyses.
Results: A hundred patients were included; their average age was 39.6 ± 10.2 years. Relapse rate of MBCT group was 28%, while that of the treatment-as-usual group was 52%. This was a significant difference (p = 0.01). Patients in MBCT also showed a significant mean change at post-intervention depression levels (PHQ-9: 7.80 ± 2.67 vs. 10.33 ± 3.13, p = 0.03). MBCT session attendance was good, with 85% attending ≥6 sessions. There were no serious adverse events. These data raise the possibility that MBCT may have prophylactic effects on relapse into depression.
Conclusion: In relapse rates and in depressive symptoms in patients with recurrent depression compared to those receiving treatment as-usual. The findings emphasize that MBCT can be an effective adjunct to treatment-as-usual, particularly for those at high risk of recurrent depression. The integration of MBCT into preventive treatment approaches could lead to decreased long-term disease severity and healthcare costs. Large-scale trials are needed to establish efficacy and investigate mechanism of prolonged protection.
References
2. Belge JB, Sabbe ACF, Sabbe B. An update on pharmacotherapy for recurrent depression in 2022. Expert opinion on pharmacotherapy. 2023;24(12):1387-94.
3. Cosci F, Guidi J, Mansueto G, Fava GA. Psychotherapy in recurrent depression: efficacy, pitfalls, and recommendations. Expert review of neurotherapeutics. 2020;20(11):1169-75.
4. Czerwińska A, Pawłowski T. Cognitive dysfunctions in depression - significance, description and treatment prospects. Psychiatria polska. 2020;54(3):453-66.
5. Doupnik SK, Rudd B, Schmutte T, Worsley D, Bowden CF, McCarthy E, et al. Association of Suicide Prevention Interventions With Subsequent Suicide Attempts, Linkage to Follow-up Care, and Depression Symptoms for Acute Care Settings: A Systematic Review and Meta-analysis. JAMA psychiatry. 2020;77(10):1021-30.
6. Dudek KA, Dion-Albert L, Kaufmann FN, Tuck E, Lebel M, Menard C. Neurobiology of resilience in depression: immune and vascular insights from human and animal studies. The European journal of neuroscience. 2021;53(1):183-221.
7. Ford T, Richardson J, Wilkinson K, Smith P, Berry V, Barnhofer T, et al. Could mindfulness-based cognitive therapy prevent a lifelong recurrent course of depression or anxiety by addressing key mechanisms of vulnerability in high-risk adolescents? The British journal of psychiatry : the journal of mental science. 2020;216(4):175-7.
8. Frank P, Batty GD, Pentti J, Jokela M, Poole L, Ervasti J, et al. Association Between Depression and Physical Conditions Requiring Hospitalization. JAMA psychiatry. 2023;80(7):690-9.
9. Hariyani N, Bramantoro T, Nair R, Singh A, Sengupta K. Depression symptoms and recurrent aphthous stomatitis-Evidence from a population-based study in Indonesia. Oral diseases. 2020;26(5):948-54.
10. Irwin MR, Carrillo C, Sadeghi N, Bjurstrom MF, Breen EC, Olmstead R. Prevention of Incident and Recurrent Major Depression in Older Adults With Insomnia: A Randomized Clinical Trial. JAMA psychiatry. 2022;79(1):33-41.
11. Jaffee SR, Sligo JL, McAnally HM, Bolton AE, Baxter JM, Hancox RJ. Early-onset and recurrent depression in parents increases risk of intergenerational transmission to adolescent offspring. Journal of child psychology and psychiatry, and allied disciplines. 2021;62(8):979-88.
12. Kofod J, Elfving B, Nielsen EH, Mors O, Köhler-Forsberg O. Depression and inflammation: Correlation between changes in inflammatory markers with antidepressant response and long-term prognosis. European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology. 2022;54:116-25.
13. Kovich H, Kim W, Quaste AM. Pharmacologic Treatment of Depression. American family physician. 2023;107(2):173-81.
14. Lee SH, Cho SJ. Cognitive Behavioral Therapy and Mindfulness-Based Cognitive Therapy for Depressive Disorders. Advances in experimental medicine and biology. 2021;1305:295-310.
15. Mangione CM, Barry MJ, Nicholson WK, Cabana M, Chelmow D, Coker TR, et al. Screening for Depression and Suicide Risk in Children and Adolescents: US Preventive Services Task Force Recommendation Statement. Jama. 2022;328(15):1534-42.
16. Monroe SM, Harkness KL. Major Depression and Its Recurrences: Life Course Matters. Annual review of clinical psychology. 2022;18:329-57.
17. Okereke OI, Reynolds CF, 3rd, Mischoulon D, Chang G, Vyas CM, Cook NR, et al. Effect of Long-term Vitamin D3 Supplementation vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial. Jama. 2020;324(5):471-80.
18. Okereke OI, Vyas CM, Mischoulon D, Chang G, Cook NR, Weinberg A, et al. Effect of Long-term Supplementation With Marine Omega-3 Fatty Acids vs Placebo on Risk of Depression or Clinically Relevant Depressive Symptoms and on Change in Mood Scores: A Randomized Clinical Trial. Jama. 2021;326(23):2385-94.
19. Powell V, Agha SS, Jones RB, Eyre O, Stephens A, Weavers B, et al. ADHD in adults with recurrent depression. Journal of affective disorders. 2021;295:1153-60.
20. Schramm E, Klein DN, Elsaesser M, Furukawa TA, Domschke K. Review of dysthymia and persistent depressive disorder: history, correlates, and clinical implications. The lancet Psychiatry. 2020;7(9):801-12.
21. van der Velden AM, Scholl J, Elmholdt EM, Fjorback LO, Harmer CJ, Lazar SW, et al. Mindfulness Training Changes Brain Dynamics During Depressive Rumination: A Randomized Controlled Trial. Biological psychiatry. 2023;93(3):233-42.
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Muhammad kamran khan
Assistant Professor Department of Psychiatry Qazi Hussain Ahmed Medical Complex Nowshera
Khalil Azam
Assistant Professor Department of Psychiatry Qazi Hussain Ahmed Medical Complex Nowshera
Raees Ahmed
Consultant psychiatrist in Wapda teaching hospital Lahore
Rabia Asghar
Assistant Professor psychiatry department Shifa college of medicine Islamabad
Aasma Kiyani
Consultant psychiatrist National Institute of Rehabilitation Medicine (NIRM)