Hostname: page-component-78c5997874-94fs2 Total loading time: 0 Render date: 2024-11-11T10:47:17.724Z Has data issue: false hasContentIssue false

The Long-Term Effects of Mindfulness-Based Cognitive Therapy as a Relapse Prevention Treatment for Major Depressive Disorder

Published online by Cambridge University Press:  07 April 2010

Kate L. Mathew*
Affiliation:
University of Adelaide, Australia
Hayley S. Whitford
Affiliation:
University of Adelaide, Australia
Maura A. Kenny
Affiliation:
Centre for the Treatment of Anxiety and Depression, Thebarton, Australia
Linley A. Denson
Affiliation:
University of Adelaide, Australia
*
Reprint requests to Kate L. Mathew, School of Psychology, Level 4, Hughes Building, The University of Adelaide, South Australia 5005, Australia. E-mail: kmathew@adam.com.au

Abstract

Background: Mindfulness-based Cognitive Therapy (MBCT) is a relapse prevention treatment for major depressive disorder. Method: An observational clinical audit of 39 participants explored the long-term effects of MBCT using standardized measures of depression (BDI-II), rumination (RSS), and mindfulness (MAAS). Results: MBCT was associated with statistically significant reductions in depression from pre to post treatment. Gains were maintained over time (Group 1, 1–12 months, p = .002; Group 2, 13–24 months, p = .001; Group 3, 25–34 months, p = .04). Depression scores in Group 3 did begin to worsen, yet were still within the mild range of the BDI-II. Treatment variables such as attendance at “booster” sessions and ongoing mindfulness practice correlated with better depression outcomes (p = .003 and p = .03 respectively). There was a strong negative correlation between rumination and mindful attention (p < .001), consistent with a proposed mechanism of metacognition in the efficacy of MBCT. Conclusion: It is suggested that ongoing MBCT skills and practice may be important for relapse prevention over the longer term. Larger randomized studies of the mechanisms of MBCT with longer follow-up periods are recommended.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrews, J. G. and the Tolkien II Team (2006). Tolkien II. A Needs Based, Costed Stepped-care Model for Mental Health Services. Sydney, Australia: World Health Organization Collaborating Centre for Classifications in Mental Health.Google Scholar
Baer, R. A. (2003). Mindfulness training as a clinical intervention: a conceptual and empirical review. Clinical Psychology: Science and Practice, 10, 125134.Google Scholar
Beck, A. T., Rush, A. J., Shaw, B. F. and Emery, G. (1979). Cognitive Therapy of Depression. New York: Guilford Press.Google Scholar
Beck, A., Steer, R. A., Ball, R. and Ranieri, W. F. (1996). Comparison of Beck Depression Inventories -IA and -II in psychiatric outpatients. Journal of Personality Assessment, 67, 588597.CrossRefGoogle Scholar
Broderick, P. C. (2005). Mindfulness and coping with dysphoric mood: contrasts with rumination and distraction. Cognitive Therapy and Research, 29, 501510.CrossRefGoogle Scholar
Brown, K. W. and Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822848.CrossRefGoogle ScholarPubMed
Coelho, H. F., Canter, P. H. and Ernst, E. (2007). Mindfulness-based cognitive therapy: evaluating current evidence and informing future research. Journal of Consulting and Clinical Psychology, 75, 10001005.CrossRefGoogle ScholarPubMed
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Hillsdale, NJ: Lawrence Erlbaum Associates.Google Scholar
Conway, M., Csank, P. A. R., Holm, S. L. and Blake, C. K. (2000). On assessing individual differences in rumination on sadness. Journal of Personality Assessment, 75, 404425.CrossRefGoogle ScholarPubMed
Cooper, C., Bebbington, P., King, M., Brugha, T., Meltzer, H., Bhugra, D. and Jenkins, R. (2007). Why people do not take their psychotropic drugs as prescribed: results of the 2000 National Psychiatric Morbidity Survey. Acta Psychiatrica Scandinavica, 116, 4753.CrossRefGoogle Scholar
Eisendrath, S. J., Delucchi, K., Bitner, R., Fenimore, P., Smit, M. and McLane, M. (2008) Mindfulness-based cognitive therapy for treatment-resistant depression: a pilot study. Psychotherapy and Psychosomatics, 77, 319320.CrossRefGoogle ScholarPubMed
Ellis, P. (2004). Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines team for depression. Australian and New Zealand Journal of Psychiatry, 38, 389407.Google Scholar
Hart, A. B., Craighead, W. E. and Craighead, L. W. (2001). Predicting recurrence of major depressive disorder in young adults: a prospective study. Journal of Abnormal Psychology, 110, 633643.CrossRefGoogle ScholarPubMed
Hollon, S. D., DeRubeis, R. J., Shelton, R. C., Amsterdam, J. D., Ronald, M., Solomon, R. M., O'Reardon, J. P., Lovett, M. L., Young, P. R., Haman, K. L., Freeman, B. B. and Gallop, R. (2005). Prevention of relapse following cognitive therapy vs. medications in moderate to severe depression. Archives of General Psychiatry, 62, 417422.CrossRefGoogle ScholarPubMed
Hyde, J. S., Mezulis, A. H. and Abramson, L. Y. (2008).The ABC's of depression: integrating affective, biological and cognitive models to explain the emergence of the gender differences in depression. Psychological Review, 115, 291313.CrossRefGoogle Scholar
Judd, L. L., Akiskal, H. S., Zeller, P. J., Paulus, M., Leon, A. C., Maser, J. D., Endicott, J., Coryell, W., Kunovac, J. L., Mueller, T. I., Rice, J. P. and Keller, M. B. (2000). Psychosocial disability during the long-term course of unipolar major depressive disorder. Archives of General Psychiatry, 57, 375380.CrossRefGoogle ScholarPubMed
Kenny, M. A. and Williams, J. M. G. (2007). Treatment-resistant depressed patients show a good response to mindfulness-based cognitive therapy. Behaviour Research and Therapy, 45, 617625.CrossRefGoogle ScholarPubMed
Kingston, T., Dooley, B., Bates, A., Lawlor, E. and Malone, K. (2007). Mindfulness-based cognitive therapy for residual depressive symptoms. Psychology and Psychotherapy: Theory, Research and Practice, 80, 193203.CrossRefGoogle ScholarPubMed
Kuyken, W., Byford, S., Taylor, R. S., Watkins, E., Holden, E., White, K., Barrett, B., Byng, R., Evans, A., Mullen, E. and Teasdale, J. (2008). Mindfulness-based cognitive therapy to prevent relapse in recurrent depression. Journal of Consulting and Clinical Psychology, 76, 966978.CrossRefGoogle ScholarPubMed
Ma, H. S. and Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 3140.CrossRefGoogle ScholarPubMed
Mueller, T. I., Leon, A. C. and Keller, M. B. (1999). Recurrence after recovery from major depressive disorder during 15 years of observational follow-up. American Journal of Psychiatry, 156, 10001006.CrossRefGoogle ScholarPubMed
National Institute for Clinical Excellence (2004). Depression: management of depression in primary and secondary care (Clinical Guideline No. 23-amended 2007). Retrieved 12 May 2009, from www.nice.org.uk/CG023NICEguidelineGoogle Scholar
Nolen-Hoeksema, S. (1991). Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology, 100, 569582.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S. and Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: the 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115121.CrossRefGoogle ScholarPubMed
Nolen-Hoeksema, S. and Morrow, J. (1993). Effects of rumination and distraction on naturally occurring depressed mood. Cognition and Emotion, 7, 561570.CrossRefGoogle Scholar
Ree, M. J. and Craigie, M. A. (2007). Outcomes following mindfulness-based cognitive therapy in a heterogeneous sample of adult outpatients. Behaviour Change, 24, 7086.CrossRefGoogle Scholar
Segal, Z. V., Williams, J. M. G. and Teasdale, J. D. (2002). Mindfulness-based Cognitive Therapy for Depression: a new approach to preventing relapse. New York: Guilford Press.Google Scholar
Singer, A. R. and Dobson, K. S. (2007). An experimental investigation of the cognitive vulnerability to depression. Behavior Research and Therapy, 45, 563575.CrossRefGoogle ScholarPubMed
Teasdale, J. D., Segal, Z. V. and Williams, J. M. G. (1995). How does cognitive therapy prevent depressive relapse and why should attentional control (mindfulness) training help? Behavior Research and Therapy, 33, 2539.CrossRefGoogle ScholarPubMed
Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M. and Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68, 615623.CrossRefGoogle ScholarPubMed
van Schaik, D. J. F., Klein, A. F. J., van Hout, H. P. J., van Marwijk, H. W. J., Beekman, A. T. F., de Haan, M. and van Dyck, R. (2004). Patients’ preferences in the treatment of depressive disorder in primary care. Psychiatry and Primary Care, 26, 184189.Google ScholarPubMed
Vittengl, J. R., Clark, L., Dunn, T. W. and Jarrett, R. B. (2007). Reducing relapse and recurrence in unipolar depression: a comparative meta-analysis of cognitive-behavioural therapy's effects. Journal of Consulting and Clinical Psychology, 75, 475488.CrossRefGoogle Scholar
Watkins, E. and Moulds, M. (2005). Positive beliefs about rumination in depression: a replication and extension. Personality and Individual Differences, 39, 7382.CrossRefGoogle Scholar
Wells, A. and Matthews, G. (1996). Modeling cognition in emotional disorder: the S-REF model. Behaviour Research and Therapy, 34, 881888.CrossRefGoogle ScholarPubMed
World Health Organization (2008). Depression. Retrieved 17 July 2008, from http://www.who.int/mental_health/management/depression/definition/en/Google Scholar
Submit a response

Comments

No Comments have been published for this article.