Cognitive Behaviour Therapy A peer reviewed, multidisciplinary journal devoted to the application of behavioural and cognitive sciences to clinical psychology and psychotherapy.
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Mindfulness-based cognitive therapy may help reduce current depression, but more long-term studies are needed.
Depressive disorders are an extremely common category of mental health conditions around the world. Among all mental and substance use disorders, depression accounts for the largest proportion of disease burden (i.e., years that an individual lives with a disease, years of life lost due to a disease; Whifeford et al., 2013). Some symptoms of depression include feeling sad or “down,” losing interest in activities one previously enjoyed, feeling a loss of energy, and even having thoughts of suicide (APA, 2013). Depression can have a huge impact on the lives and families of individuals suffering from this disease.
Thankfully, there have been significant efforts to develop treatment for depression. These include a variety of psychological treatments as well as medications (i.e., antidepressants). Mindfulness-based cognitive therapy (MBCT) is one treatment approach that has become increasingly popular in the past two decades (Segal, Williams, & Teasdale, 2002). MBCT was developed through combining two distinct approaches to addressing mental pain. The mindfulness component was adapted from mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1990) which is a treatment approach derived from Buddhist contemplative practices. In MBSR, participants are taught meditation techniques to train themselves to focus on present moment experience with curiosity and openness and with less of our usual judgment (e.g., self-criticism). The cognitive therapy component used techniques drawn from the cognitive behavioral therapy tradition (Beck, Rush, Shaw, & Emery, 1979). Yet instead of learning to challenge specific errors in thinking, participants learn to recognize that thoughts are only thoughts and may not have the “realness” that we typically attribute to them (Segal et al., 2002).
As many individuals with depression will have recurrent periods of depression across their lifespan, MBCT was designed specifically to prevent the relapse of depression among individuals with a history of depression who are not currently experiencing symptoms. There is now strong evidence that MBCT is effective at preventing the return of depression symptoms (Kuyken et al., 2016). It also appears that interventions based on mindfulness meditation in general may reduce depressive symptoms (Goldberg et al., 2018). However, it has not been determined whether MBCT specifically is effective at reducing depression among those having current symptoms.
Our meta-analysis aimed at addressing this question – how effective is MBCT when provided to individuals with current depressive symptoms? We included 13 studies representing 1,046 participants with elevated depression symptoms (Goldberg et al., in press). We compared the effects of MBCT to either other active therapies or non-active control conditions (e.g., waitlist conditions). We found that at the end of treatment, MBCT was superior to non-active control conditions and showed results similar to other active therapies. At long-term follow-up (which occurred on average almost six months after the end of treatment), MBCT was similar to both non-active and active therapies. However, only two studies examined the long-term effects of MBCT in comparison to non-active therapies, which could explain why differences were not detected.
Taken together, our study suggests that MBCT may be a promising approach for individuals with current depressive symptoms, but more research is needed. In particular, questions remain regarding the long-term effects of MBCT in comparison to non-active therapies.
Photo: World Peace Initiative
Text: Dr Simon Goldberg
Read the full paper:
Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Kearney, D. J., & Simpson, T. L. (2019). Mindfulness-based cognitive therapy for the treatment of current depressive symptoms: A meta-analysis. Cognitive Behaviour Therapy, 10.1080/16506073.2018.1556330.
Dr Simon Goldberg – one of the authors
References:
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
- Beck, A.T., Rush, A.J., Shaw, B.F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.
- Goldberg, S. B., Tucker, R. P., Greene, P. A., Davidson, R. J., Kearney, D. J., & Simpson, T.L. (in press). Mindfulness-based cognitive therapy for patients with current depression: A meta-analysis. Cognitive Behaviour Therapy.
- Goldberg, S.B., Tucker, R.P., Greene, P.A., Davidson, R.J., Wampold, B.E., Kearney, D.J., & Simpson, T.L. (2018). Mindfulness-based interventions for psychiatric disorders: A meta-analysis. Clinical Psychology Review, 59, 52-60. doi:10.1016/j.cpr.2017.10.011
- Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness. New York: Delta.
- Kuyken, W., Warren, F.C., Taylor, R.S., Whalley, B., Crane, C.,…& Dalgleish, T. (2016). Efficacy of mindfulness-based cognitive therapy in prevention of depressive relapse: An individual patient data meta-analysis from randomized trials. JAMA Psychiatry, 73(6), 565-574 doi:10.1001/jamapsychiatry.2016.0076
- Segal, Z., Williams, J.W., & Teasdale, J. (2002). Mindfulness-based cognitive therapy for depression: A new approach to preventing relapse. New York: Guilford Press.
- Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., … & Vos, T. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. The Lancet, 382(9904), 1575-1586.
