The effectiveness of mindfulness-based cognitive therapy for major depressive disorder: evidence from routine outcome monitoring data

Abstract

Background Meta-analyses show efficacy of mindfulness-based cognitive therapy (MBCT) in terms of relapse prevention and depressive symptom reduction in patients with major depressive disorder (MDD). However, most studies have been conducted in controlled research settings. Aims We aimed to investigate the effectiveness of MBCT in patients with MDD presenting in real-world clinical practice. Moreover, we assessed whether guideline recommendations for MBCT allocation in regard to recurrence and remission status of MDD hold in clinical practice. Method This study assessed a naturalistic cohort of patients with (recurrent) MDD, either current or in remission (n = 765), who received MBCT in a university hospital out-patient clinic in The Netherlands. Outcome measures were self-reported depressive symptoms, worry, mindfulness skills and self-compassion. Predictors were MDD recurrence and remission status, and clinical and sociodemographic variables. Outcome and predictor analyses were conducted with linear regression. Results MBCT adherence was high (94%). Patients with a lower level of education had a higher chance of non-adherence. Attending more sessions positively influenced improvement in depressive symptoms. Depressive symptoms significantly reduced from pre- to post-MBCT (Δ mean = 7.7, 95%CI = 7.0–8.5, Cohen's d = 0.75). Improvement of depressive symptoms was independent from MDD recurrence and remission status. Unemployed patients showed less favourable outcomes. Worry, mindfulness skills and self-compassion all significantly improved. These improvements were related to changes in depressive symptoms. Conclusions Previous efficacy results in controlled research settings are maintained in clinical practice. Results illustrate that MBCT is effective in routine clinical practice for patients suffering from MDD, irrespective of MDD recurrence and remission status.

Self‐compassion and related factors in severe mental illness: A scoping review

“…The most commonly used intervention for major depressive disorder was mindfulness‐based cognitive therapy (MBCT). Four articles—Geurts et al (2020); Schoenberg and Speckens (2015); Williams et al (2020); and Hanssen et al (2019)—introduced a standardized MBCT 8‐week program designed as a nonrandomized control trial and reported significant improvement in SC scores after intervention, compared to baseline. Schuling et al (2020) conducted a randomized controlled trial (RCT) using mindfulness‐based compassionate living (MBCL), which is a follow‐up to MBCT, aimed at cultivating compassion for patients who previously received MBCT.…”

“…Furthermore, changes in SC after follow‐up affected depression. Geurts et al (2020) reported that increased change in SC is negatively correlated with decreased changes in depression, before and after the MBCT intervention. Schuling et al (2020) reported that the reduction effects in depression after the MBCL intervention were moderated by SC, but not by rumination and mindfulness.…”

“…First, we address the mindfulness‐based interventions—such as MBCT and MBCL—that were most frequently used in the included articles. All eligible intervention studies using MBCT (Geurts et al, 2020; Hanssen et al, 2019; Schoenberg & Speckens, 2015; Williams et al, 2020) and MBCL (Schuling et al, 2020) showed improved SC in patients with major depressive disorder. Although several meta‐analyses have examined the efficacy of MBCT, its effect on SC has been neglected.…”

Electrophysiological correlates of mindfulness in patients with major depressive disorder

“…Mindfulness-based interventions (MBI) integrated the essence of traditional mindfulness practice with contemporary psychological practice and have recently gained much interest in the scientific world and in the therapy of depression (Hofmann et al, 2010;Gu et al, 2015;Segal and Walsh, 2016;Bulzacka et al, 2018;Cladder-Micus et al, 2018;Geurts et al, 2020;Ninomiya et al, 2020).…”

Mindfulness based cognitive therapy (MBCT) reduces depression-related self-referential processing in patients with bipolar disorder: an exploratory task-based study

“…For patients with recurrent unipolar depression, MBCT reduces both relapse (Kuyken et al, 2016) and severity of depressive symptoms (Geurts, Compen, et al, 2020;Goldberg et al, 2019;Strauss et al, 2014). In a systematic review, Lovas & Schuman-Olivier (2018) described MBCT as a promising treatment for patients with BD.…”