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Major depressive disorder (MDD) is currently ranked the third leading cause of disability in the world. Treatment-resistant depression (TRD) causes the majority of MDD disability. Strikingly, 50% of individuals with MDD will fail to remit with 2 adequate trials of antidepressant medications, thus qualifying as treatment resistant. Current pharmacological and psychotherapeutic treatment strategies for TRD are limited in effectiveness, thus, new interventions are needed. Mindfulness-Based Cognitive Therapy (MBCT) is a new psychotherapeutic treatment with established efficacy in preventing relapse of depression for individuals in complete remission. MBCT is a group-based, 8-week intervention that uses mindfulness meditation as its core therapeutic technique. It teaches people to have a different relationship to depressive thoughts and feelings. Strategies are focused on decreasing rumination, enhancing self-compassion, increasing acceptance, and decreasing avoidance. This modified version of MCBT, which includes the use of metaphor and adaptations of the original intervention, will be discussed through the clinical case of a woman with long-standing TRD. A brief review of the current MBCT literature and future directions for the treatment of TRD are discussed.
Much of the ongoing morbidity in patients suffering majordepressive disorders is related to current treatments failing to produce complete remission. Many patients can be considered to
have treatment-resistant depression (TRD), with failure to fully
remit with adequate doses and durations of 2 or more antidepressant trials [1, 2] . TRD is associated with greater disability, mortality, morbidity, somatic symptoms, risk of relapse and societal cost
[3, 4] . We report on a pilot study of mindfulness-based cognitive
therapy (MBCT) for TRD.
Much of the ongoing morbidity in patients suffering majordepressive disorders is related to current treatments failing to produce complete remission. Many patients can be considered to
have treatment-resistant depression (TRD), with failure to fully
remit with adequate doses and durations of 2 or more antidepressant trials [1, 2] . TRD is associated with greater disability, mortality, morbidity, somatic symptoms, risk of relapse and societal cost
[3, 4] . We report on a pilot study of mindfulness-based cognitive
therapy (MBCT) for TRD.