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Mindfulness-based cognitive therapy (MBCT) is an effective treatment for reducing depressive relapse as well as residual depressive symptoms among adults with recurrent depression but the specific mechanisms through which this treatment works have yet to be examined. This study investigated MBCT's immediate (pre to post) effects on depressive symptoms and its potential theory-driven change mechanisms in a wait-list randomized control trial. Recurrently depressed patients, the majority of them in partial remission, were randomized to either an 8-week MBCT group (N = 26) or a wait-list control group (N = 19). Participants completed measures of depressive symptoms as well as measures of rumination and trait mindfulness before and after the intervention. Consistent with the MBCT change theory, bootstrapping-based mediation analyses demonstrated that reductions in brooding (an aspect of rumination) and increases in mindfulness independently and uniquely (accounting for other mediators) mediated the effects of the intervention on depressive symptoms. Given the pre-post design and the lack of temporal precedence, these findings provide initial evidence supporting the notion that mindfulness and brooding may be important change processes through which MBCT affects depressive outcomes.
Background: Many antidepressant medications (ADM) are associated with disruptions in sleep continuity that can compromise medication adherence and impede successful treatment. The present study investigated whether mindfulness meditation (MM) training could improve self-reported and objectively measured polysomnographic (PSG) sleep profiles in depressed individuals who had achieved at least partial remission with ADM, but still had residual sleep complaints. Methods: Twenty-three ADM users with sleep complaints were randomized into an 8-week Mindfulness-Based Cognitive Therapy (MBCT) course or a waitlist control condition. Pre-post measurements included PSG sleep studies and subjectively reported sleep, residual depression symptoms. Results: Compared to controls, the MBCT participants improved on both PSG and subjective measures of sleep. They showed a pattern of decreased wake time and increased sleep efficiency. Sleep depth, as measured by stage 1 and slow-wave sleep, did not change as a result of mindfulness training. Conclusions: MM is associated with increases in both objectively and subjectively measured sleep continuity in ADM users. MM training may serve as more desirable and cost-effective alternative to discontinuation or supplementation with hypnotics, and may contribute to a more sustainable recovery from depression.