The biggest meta analytical study concerning mindfulness based cognitive therapy for recurrent depression was published in an article by JAMA Psychiatry yesterday, proving that mindfulness based cognitive therapy (MBCT) is in fact linked to reducing recurrent symptoms in depressed patients compared with other alternative treatments. The article was a review of Kuyken et al’s study that was published in Lancet in 2015. Mindfulness based cognitive therapy has particularly proven to be effective for those suffering from recurrent depression and has secured its position as an alternative treatment method in the field of psychiatry.
The study involved data analysis of 1,258 patients from nine randomized clinical trials of MBCT over a period of 60-week follow-up conducted in the UK, Belgium, Canada, the Netherlands and Switzerland. Some 944 of the participants were female and the mean age of the 1,258 patients was 47.1 years while the mean age of onset was 26 years with 57.8 percent of them previously been a part of a depressive episode. Out of the complete data set of 1,258 participants, 636 had qualifications before degree level, 509 had at least degree level qualifications and 85 had no qualifications. Furthermore, 726 were married or had a partner, 279 were divorced, separated or widowed and 234 were single.
Results demonstrate how MBCT can be used as an effective treatment option in treating depression. Both 2 stage and 1 stage meta analyses were used and results revealed that during the nine trials and 60-week follow-up, those who had received MBCT treatment had a 38% relapse rate whereas the control group which did not receive MBCT had a 49% relapse rate. Socio demographic and psychiatric variables such as age of onset, marital status and number of previous episodes were also closely studied and it was found that all these variables were significantly associated with a risk of relapse within 60 weeks. No participant reported side effects.
Even with numerous treatment options, the rate of relapse in depression is still very high. Lead author of the study Willem Kuyken, from University of Oxford, says, ‘Depression is a recurrent disorder. Without ongoing treatment, as many as four out of five people with depression relapse at some point.’ MBCT helps those with recurrent relapses by making them recognize the triggers and thoughts and feelings which lead to the relapse and helps them in reducing their symptoms. It was found that those who had severe symptoms right before treatment responded better than those who were suffering from mild or moderate symptoms.
Dr Zindel Segal, a psychology professor at the University of Toronto Scarborough, has also explained how MBCT is a unique treatment method and compared with anti depressants that a patient is likely to take for many years, MBCT provides the patient with protection after they have recovered from depression. This does not mean that one stops taking anti-depressants without the required physician or psychiatrist telling them to do so but it simply means that MBCT is a new method which can be used after the course of anti-depressants to keep the recovery intact. It is specifically useful for those who prefer using other treatment methods as opposed to medication, or are unable to stick to the medication and its required dose, or are simply not comfortable with taking it due to the proposed side effects. For women, particularly who are pregnant or are breastfeeding, MBCT is a very good option to consider.
Depression is one of the most common mental health problems that exist today affecting more than 350 million people worldwide. There is no single cause of why depression occurs and the reasons can vary from person to person. Recurrent depression is the same as depression with the same symptoms such as sense of hopelessness and helplessness, lack of sleep and appetite, persistently feeling fatigued, loss of pleasure and anhedonia and feelings of irritability. The only major difference is that in recurrent depression the symptoms come and go and may disappear for weeks but then strike back after days, weeks or even years. The more important question to be asked when someone gets affected by depression or recurrent depression is what should be done about it now; in other words, what treatment methods are available out there.
MCBT was not originally designed to treat psychiatric conditions. They are still considered fairly new and have recently been applied in therapeutic practices. MBCT basically teaches individuals with skills and practices that change the way people think and make them more aware of their current scenarios and automatic thoughts and feelings which impact their behavior and emotions and result in a downward spiral for depression. Sessions last from two to two and a half hours typically and patients are taught techniques such as meditation, deep breathing and other relaxation techniques. Along with these, cognitive techniques such as role playing and goal setting are also part of the MBCT program and an overall sense of being in charge of your own life is achieved and instilled through this approach.
With the advent of new techniques, there is hope and room for further advancements to be made to combat depression entirely. Authors of the study are pleased with the results as MBCT can also be considered as a new alternative treatment option along with anti-depressants and other therapeutic treatments. However, more research needs to be done and they suggest that future trials should be carried out with even longer follow-up periods, cost effective analyses and other important variables that might have a role to play such as race/ethnicity and employment status so that more data can be generated leading to more systematic results.
Data for the study was gathered through various sources such as peer reviewed journals from EMBASE, PubMEd/Medline, PsycINFO, Web of Science, Scopus, and the Cochrane Central Register of Controlled Trials from the first available year to 22 November, 2014.