Mindfulness-based cognitive therapy: Evaluating current evidence and informing future research.

Abstract

Mindfulness-based cognitive therapy (MBCT) is a recently developed class-based program designed to prevent relapse or recurrence of major depression (Z. V. Segal, J. M. G. Williams, & J. Teasdale, 2002). Although research in this area is in its infancy, MBCT is generally discussed as a promising therapy in terms of clinical effectiveness. The aim of this review was to outline the evidence that contributes to this current viewpoint and to evaluate the strengths and weaknesses of this evidence to inform future research. By systematically searching 6 electronic databases and the reference lists of retrieved articles, the authors identified 4 relevant studies: 2 randomized clinical trials, 1 study based on a subset of 1 of these trials, and 1 nonrandomized trial. The authors evaluated these trials and discussed methodological issues in the context of future research. The current evidence from the randomized trials suggests that, for patients with 3 or more previous depressive episodes, MBCT has an additive benefit to usual care. However, because of the nature of the control groups, these findings cannot be attributed to MBCT-specific effects. Further research is necessary to clarify whether MBCT does have any specific effects.

The effectiveness and cost-effectiveness of mindfulness-based cognitive therapy compared with maintenance antidepressant treatment in the prevention of depressive relapse/recurrence: results of a randomised controlled trial (the PREVENT study)

“…Coelho et al 26 found no evidence of the 'specific effectiveness of MBCT, despite this being the logical progression from the current research' (p. 1004). In other words, no trials had shown whether MBCT works through its specific hypothesised mechanisms and/or through non-specific cognitive-behavioural, psychoeducation and group/therapist support components.…”

“…26 This is the same evidence that led to NICE's guidance that MBCT be offered as a relapse prevention approach to patients with three or more episodes of depression.…”

“…Higher scores represent greater depression severity (range 0-63) and minimal (0-13), mild (14)(15)(16)(17)(18)(19), moderate (20)(21)(22)(23)(24)(25)(26)(27)(28) and severe (29-63) symptom severity ranges have been specified. The BDI-II was administered at every assessment during the 24-month follow-up period.…”

“…We used the systematic review of MBCT compared with usual care for patients with recurrent depression that reported HRs of 0.28-0.47 for relapse/recurrence. 26 We applied several conservative assumptions (first row of Table 3). First, even though the pilot trial data suggest that the HR was improving in favour of MBCT as the length of follow-up increased, 28 we assumed a HR of 0.63 at 15 months to power the trial at 24-months' follow-up.…”

The Effectiveness of Mindfulness-Based Cognitive Group Therapy in Reducing Negative Automatic Thoughts and Dysfunctional Attitudes in Cancer Patients

“…Recent findings have revealed that MBCT increases selfassertiveness, self-esteem, quality of life and positive feelings [28]. Mindfulness training also ameliorates psychological distress [29], depression and stress symptoms [30], improves mental, physical, emotional and spiritual wellbeing [31] and can consequently reduce negative automatic thoughts.…”