Mindfulness-Based Cognitive Therapy Intervention for the Treatment of Late-Life Depression and Anxiety Symptoms in Primary Care: A Randomized Controlled Trial

Torres-Platas, Susana G.; Escobar, Sophia; Belliveau, Claudia; Wu, Joyce; Sasi, Neeti; Fotso, Jocelyn; Potes, Angela; Thomas, Zoë; Goodman, Allana; Looper, Karl; Segal, Marilyn; Berlim, Marcelo T.; Vasudev, Akshya; Moscovitz, Nona; Rej, Soham

doi:10.1159/000501214

Cited by 19 publications

(22 citation statements)

References 6 publications

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“…We previously published an 8‐week assessor blind, two‐arm RCT of MBCT vs TAU for LLD and LLA (between September 2016 and October 2018) 5 . Before the trial began, ethics approval was granted by the Bureau d'examen de la recherche of the CIUSSS du Centre‐Ouest‐de‐l'Île‐de‐Montréal.…”

Section: Methodsmentioning

confidence: 99%

“…Eligible participants were ≥ 60 years old and had symptoms of depression and/or anxiety (score ≥10 on the patient health questionnaire [PHQ‐9] and/or General Anxiety Disorder 7‐Item Scale [GAD‐7]). Selected exclusion criteria included acute psychotic symptoms, severe personality disorder, and acute suicidal ideation/intent, and/or inability to communicate in either English or French 5 . Informed consent was obtained, and the privacy rights of the participants were maintained.…”

Section: Methodsmentioning

confidence: 99%

“…This structured 8‐week program incorporates components of cognitive behavioral therapy (CBT), psycho‐education, and mindfulness practices to foster nonjudgmental present‐moment awareness 4 . Our team conducted an 8‐week randomized controlled trial (RCT) which demonstrated that group MBCT, compared to treatment as usual (TAU), improved symptoms of LLD and LLA in primary care (Cohen's d = 0.86 and d = 0.99, respectively) 5 . However, a recent meta‐analysis found that 78% of clinical worsening of depressive symptoms tends to occur within 6 months following the end of acute phase treatment 6 .…”

Section: Introductionmentioning

confidence: 99%

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Continuation Sessions of Mindfulness‐Based Cognitive Therapy (MBCT‐C) vs. Treatment as Usual in Late‐Life Depression and Anxiety: An Open‐Label Extension Study

Dikaios

Escobar

Nassim

et al. 2020

Int J Geriat Psychiatry

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Objectives Mindfulness‐based cognitive therapy (MBCT) is a novel treatment for depression. Our published randomized controlled trial shows that MBCT improves symptoms of late‐life depression (LLD) and anxiety (LLA). We now examine whether continuation sessions of MBCT (MBCT‐C) can prevent LLD/LLA symptom recurrence. Methods/design Following an 8‐week MBCT intervention, we compared patients who attended open‐label weekly 1‐hour MBCT‐C for another 26 weeks (n = 10) vs those who did not (n = 17) for change in depressive and anxiety symptoms. Results While there were no significant differences between groups on depressive or anxiety symptom severities between 8‐ and 34‐ weeks (Cohen's d = 0.045), we observed a small clinical effect of MBCT‐C on symptoms of anxiety (d = 0.29). Conclusions These preliminary results suggest that MBCT‐C may be somewhat beneficial for symptoms of LLA, but not for LLD. Healthcare providers should consider what is clinically feasible before investing time and resources into MBCT‐C in older adults with depression and/or anxiety.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Continuation Sessions of Mindfulness‐Based Cognitive Therapy (MBCT‐C) vs. Treatment as Usual in Late‐Life Depression and Anxiety: An Open‐Label Extension Study

Dikaios

Escobar

Nassim

et al. 2020

Int J Geriat Psychiatry

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“…While pharmacotherapy is frequently used to manage symptoms of anxiety in older adults, this approach has been related to negative side effects such as cardiovascular issues and falls [3,[19][20][21][22]. There is evidence in the research literature to suggest that older adults favor non-pharmacotherapy approaches, such as psychotherapy, but do not always have access to public mental health care, or can afford private mental health care [3,23]. Given the increased rates of anxiety due to COVID-19, there is an identified urgent need for evidence based alternatives to pharmacotherapy for the treatment of anxiety that are feasible, potentially scalable, and can be delivered at the primary care and community levels [23,24].…”

Section: Background and Rationalementioning

confidence: 99%

Video-delivered emotion-focused mindfulness therapy for late- life anxiety: study protocol for a feasibility randomized controlled trial

Hatch

Kessler

Finlayson

et al. 2021

Pilot Feasibility Stud

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Background The worldwide prevalence of anxiety in older adults is estimated at between 6 and 10%. In Canada, adults 65 and older experience anxiety at a rate of 6.4%, affecting more than 300,000 people. Anxiety in older adults has been linked to difficulties retaining new information and engaging in instrumental daily activities of living. Due to COVID-19 restrictions, novel methods of delivering therapy programs remotely are needed; however, data is limited. There is some evidence that older adults prefer non-pharmacological approaches for anxiety that can be delivered in the community. Emotion-focused mindfulness therapy (EFMT) is a mindfulness-based intervention that emphasizes meditation and observing thoughts and emotions as they arise. This emphasis has been demonstrated to reduce symptoms of anxiety in general populations. This study aims to evaluate the feasibility of EFMT with older adults. Methods This pilot feasibility randomized controlled trial will use a wait list control trial design. Due to COVID-19 restrictions, we will use telehealth delivery via Zoom rather than in-person delivery. The first 48 people to meet the eligibility criteria will be randomly allocated to either receive EFMT immediately, or in approximately 8 weeks time from enrollment (1:1 allocation ratio). Data will be collected at baseline, 8 weeks following baseline, and 16 weeks following baseline. The primary outcomes will determine the feasibility of the intervention based on recruitment, enrolment, retention, and adherence to all components of the intervention. The secondary outcome will be changes to anxiety over time. Discussion The results of this trial will determine the feasibility and potential effectiveness of video-delivered EFMT for late-life anxiety compared to no treatment. If the results are promising, a larger randomized controlled trial may be conducted. Trial registration ClinicalTrials.gov, NCT04415528. Registered on June 4, 2020 Protocol version Protocol version 2, January 2, 2021

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“…MBCT has demonstrated satisfactory treatment effects on reducing active depressive symptoms in younger adults. 25,26 However, studies of the efficacy of MBCT, particularly its immediacy effects, on older populations are limited, [27][28][29] presumably owing to differences in sample size and baseline depression levels from a mixture of sampling populations that ranged from those in remission to those currently depressed to those non-depressed with chronic back pain. Given that rumination and reduced AMS are potentially more prominent in depressed older adults, we aimed to examine the efficacy and cognitive mechanisms of MBCT in older adults with active depressive symptoms.…”

Section: Introductionmentioning

confidence: 99%

Mindfulness-Based Cognitive Therapy for Late-Life Depression: a Randomised Controlled Trial

Shih

Chan

Tai

et al. 2021

East Asian Arch Psychiatry

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Background: Rumination and overgeneral autobiographical memory are dysfunctional cognitions commonly found in older adults with depression. The theoretical underpinnings of mindfulnessbased cognitive therapy (MBCT) address the ruminative tendencies and the non-specific retrieval of autobiographical memories. This study aims to examine the efficacy and cognitive mechanisms of MBCT in older adults with active depressive symptoms. Methods: 57 older adults (mean age, 70 years) with normal cognition and mild to moderate depressive symptoms were randomly allocated to either the MBCT group or the active control group for 8 weeks. The MBCT group consisted of eight 2-hour weekly sessions and a 7-hour full-day retreat, with different themes for each class, guided mindfulness exercises, feedback and discussion, homework review, and psychoeducation. The active control group comprised a 1-hour physical exercise and a standardised health education of the specific theme with group discussion (eg fall prevention, chronic pain). Participants were assessed before and after the 8-week intervention for four outcome measures: the Hamilton Depression Rating Scale (HAMD), the Ruminative Response Scale (RRS), the Autobiographical Memory Test (AMT), and the Mindful Attention Awareness Scale (MAAS). Results: There was a significant reduction in severity of depressive symptoms (HAMD score) in both the MBCT group (F(1, 27) = 35.9, p < 0.001, η 2 = 0.57) and the active control group (F(1, 28) = 9.29, p < 0.01, η 2 = 0.24), but only the MBCT group showed substantial improvements in autobiographical memory specificity (AMT score), rumination (RRS score), and mindfulness (MAAS score). Conclusion:Although both MBCT and active control programme decrease the severity of depressive symptoms in older adults, only MBCT improves AMS, rumination, and mindfulness. Our findings provide empirical support for the theoretical underpinnings of MBCT. Older adults with more severe depression and more severe dysfunctional cognition may benefit more from the specific therapeutic effects of MBCT.

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Mindfulness-Based Cognitive Therapy Intervention for the Treatment of Late-Life Depression and Anxiety Symptoms in Primary Care: A Randomized Controlled Trial

Cited by 19 publications

References 6 publications

Continuation Sessions of Mindfulness‐Based Cognitive Therapy (MBCT‐C) vs. Treatment as Usual in Late‐Life Depression and Anxiety: An Open‐Label Extension Study

Continuation Sessions of Mindfulness‐Based Cognitive Therapy (MBCT‐C) vs. Treatment as Usual in Late‐Life Depression and Anxiety: An Open‐Label Extension Study

Video-delivered emotion-focused mindfulness therapy for late- life anxiety: study protocol for a feasibility randomized controlled trial

Mindfulness-Based Cognitive Therapy for Late-Life Depression: a Randomised Controlled Trial

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