BackgroundIt has been shown that mindfulness practice can be helpful in preventing relapse from depression. However, practicing mindfulness regularly at home is often a challenge for people with depression. Mobile phone text messaging (short message service, SMS) may be a feasible approach to assist regular mindfulness home practice.ObjectiveThe aim of this study was to evaluate the feasibility of text message–based feedback to support mindfulness practice in people with depressive symptoms after inpatient psychiatric treatment.MethodsParticipants received a manualized group introduction to three mindfulness exercises during inpatient treatment and were randomized at hospital discharge. All participants were asked to practice the exercises daily during the 4-month follow-up period. Only participants allocated to the intervention group received reinforcing feedback via mobile phone text messages after reporting their mindfulness practice via text message. Participation rates and satisfaction with the interventions were evaluated, and effects on relevant outcomes were explored.ResultsOf the 176 eligible inpatients invited to participate, 65.9% (116/176) attended the introductory mindfulness group at least once, 33.0% (58/176) were willing to participate in the study, and 41 were randomized. The majority 85% (35/41) of these participants completed the study. Among the participants allocated to the intervention group (n=21), 81% (17/21) used the text message support at least once. The average number of text messages sent during the intervention period was 14 (SD 21, range 0-91). Satisfaction rates were high. Preliminary analyses of the effects of the intervention yielded mixed results.ConclusionsFindings indicate that text messaging following inpatient treatment is feasible for some, but not for all people with depressive symptoms. Modest use of the text messaging intervention and its mixed effects imply that dose and ingredients of the intervention should be increased for this group of patients in a future full-size RCT. Such a larger study should also include a process evaluation to investigate moderators of the effect of mindfulness practice and text message feedback on clinical outcome.Trial RegistrationInternational Standard Randomized Controlled Trial Number (ISRCTN): 58808893; http://www.controlled-trials.com/ISRCTN58808893 (Archived by Webcite at http://www.webcitation.org/6pmrDRnGt)

The rate of depression appears to be in the lower range compared to rate reported from elsewhere. Some socio-cultural factors that may contribute to the present findings are discussed.

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Unlike many (clinical) outcome projects, this study was designed to measure and evaluate the effects of individual and group-analytical psychotherapy performed in its most prevalent setting: outpatient treatment in the therapist's office. Drawing on a 20 percent sample of all members of the two main associations of psychoanalytical psychotherapists in Germany a one-page questionnaire was sent through their therapists to almost 1,000 former patients. The anonymous return rate was 65 percent. Subjects were asked for self-assessment of their physical, mental, social and overall health status at three points in time: at the beginning and end of their therapy and at the time of assessment (up to five years after completing therapy). Furthermore they were to report on their use of other health care services (visits to physicians, hospital stays, prescription drug consumption) and on their work-loss days. The responses show that the self-assessed health status of patients had improved significantly by the end of the therapy, and this effect had increased even more in the 2'4 years since completing therapy. The number of days in hospital declined on an average of two-thirds, visits to physicians by one-third and work-loss days by one-half Thus a substantial part of the cost of the therapy was saved in other parts of the health system. With the exception of a better cost-benefit relationship for group psychotherapy no significant differences were found in the salutary effects between group and individual forms of therapy.