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Mindfulness and antidepressants are similarly effective against depression.

Mindfulness-based cognitive therapy (MBCT) could provide an alternative, non-drug treatment for people who do not wish to continue long-term antidepressant treatment, according to new research led by Oxford University scientists.

The results come from the first-ever large study to compare MBCT--structured training for the mind and body that aims to change the way people think and feel about their experiences-with maintenance antidepressant medication for reducing the risk of relapse in depression.

The study aimed to establish whether MBCT is superior to maintenance antidepressant treatment in terms of preventing relapse of depression. The findings show that MBCT isn't any more effective than maintenance antidepressant treatment in preventing relapse of depression. However, the results, combined with those of previous trials, suggest that MCBT may offer similar protection against depressive relapse or recurrence for people who have experienced multiple episodes of depression, with no significant difference in cost.

"Depression is a recurrent disorder. Without ongoing treatment, as many as four out of five people with depression relapse at some point," said Willem Kuyken, PhD, lead author and professor of clinical psychology at Oxford University.

"Many people, for a number of different reasons, are unable to keep on a course of medication for depression. Moreover, many people do not wish to remain on medication for indefinite periods, or cannot tolerate its side effects," said study co-author Professor Richard Byng, PhD, of Plymouth University.

MBCT was developed to help people who have experienced repeated bouts of depression by teaching them the skills to recognize and to respond constructively to the thoughts and feelings associated with relapse, thereby preventing a downward spiral into depression.

In this trial, 424 adults with recurrent major depression who were taking maintenance antidepressant medication were recruited from 95 primary care general practices across the South West of England. Participants were randomly assigned either to come off their antidepressant medication slowly and receive MBCT (212 participants), or to stay on their medication (212 participants).

Participants in the MBCT group attended eight group sessions lasting 2.25 hours each, and they were given daily home practice assignments. After the group sessions, they had the option of attending four follow-up sessions over a 12-month period. The MBCT course consists of guided mindfulness practices, group discussion, and other cognitive behavioral exercises. Those in the maintenance antidepressant group continued their medication for two years.

All trial participants were assessed at regular intervals over two years for a major depressive episode using a psychiatric diagnostic interview tool (the Structured Clinical Interview for DSM-IV).

Over the two years, relapse rates in both groups were similar--44 percent in the MBCT group against 47 percent in the maintenance antidepressant medication group.

SOURCES

* University of Oxford News, April 21, 2015: http://www.ox.ac.uk/news/2015-0421-mindfulness-based-therapy-may-offer-alternativeantidepressants

* The Lancet / Full text of article:

<http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62222-4/ fulltext>

COMPILED BY KATHLEEN MCCARTHY, THE ADVOCATE
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Title Annotation:Research Findings
Author:McCarthy, Kathleen
Publication:The Advocate (American Mental Health Counselors Association)
Date:May 1, 2015
Words:479
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