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BackgroundIndividual-based cognitive–behavioural therapy (CBT) is in short supply and expensive.
Aims
The aim of this randomised controlled trial (RCT) was to compare mindfulness-based group therapy with treatment as usual (primarily individual-based CBT) in primary care patients with depressive, anxiety or stress and adjustment disorders.
Method
This 8-week RCT (ClinicalTrials.gov ID: NCT01476371) was conducted during spring 2012 at 16 general practices in Southern Sweden. Eligible patients (aged 20–64 years) scored $10 on the Patient Health Questionnaire-9, $7 on the Hospital Anxiety and Depression Scale or 13–34 on the Montgomery–åsberg Depression Rating Scale (self-rated version). The power calculations were based on non-inferiority. In total, 215 patients were randomised. Ordinal mixed models were used for the analysis.
Results
For all scales and in both groups, the scores decreased significantly. There were no significant differences between the mindfulness and control groups.
Conclusions
Mindfulness-based group therapy was non-inferior to treatment as usual for patients with depressive, anxiety or stress and adjustment disorders.
Epidermal growth factor (EGF) and inflammatory markers have been associated with various neuro-psychiatric disorders. However, their role in mild to moderate depression and anxiety patients treated with mindfulness-based group therapy (mindfulness) or cognitive behavioral therapy (CBT) is not known. In this study we analyzed plasma levels of interleukin (IL)-6, IL-8, high sensitivity C-reactive protein (hsCRP) and EGF before (baseline) and after treatment (8 weeks) and investigated their role in response to both arms of the treatment. To cover variety of mental symptoms, treatment response was analyzed by four scales, the Montgomery–Åsberg depression rating scale (MADRS), Hospital anxiety and depression scale- Depression (HADS-D) and anxiety (HADS-A) and patients health questionnaire-9.EGF levels were significantly decreased after both mindfulness and CBT and were associated with treatment response on all scales independent of the use of tranquilizers and antidepressant treatment. Moreover, baseline EGF levels were significantly associated only with baseline scores of anxiety scale. Levels of inflammatory markers analyzed in this study, were not significantly associated with treatment response on any scale. Our findings suggest that improvement in symptoms of depression and anxiety after both mindfulness and CBT is associated with changes in EGF levels but not with the inflammatory markers.