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Mindfulness-based cognitive therapy (MBCT) has been demonstrated to be successful in the prevention of relapse in patients with recurrent major depressive disorder (MDD). With regard to its working mechanisms, it is hypothesized that mindfulness meditation influences the processing of emotional information and that it could therefore reduce cognitive vulnerability factors that are observed during and after remission of depressive episodes. In this study we investigated the effects of an 8 week MBCT training versus no intervention on the facilitation and inhibition of attention for sad versus happy faces in a group of people with a history of MDD, N = 45. The comparison group consisted of a non-treatment seeking group with a history of MDD, recruited from the community, N = 26. At baseline, we found that formerly depressed patients who applied for MBCT training inhibited attention for positive information, and showed facilitation of attention for negative information. However, the comparison group did not show similar attentional characteristics. After MBCT, participants showed a reduced facilitation of attention for negative information and a reduced inhibition of attention for positive information, which is indicative of open attention towards all emotional information.
Mindfulness-based cognitive therapy (MBCT) has been demonstrated to be successful in the prevention of relapse in patients with recurrent major depressive disorder (MDD). With regard to its working mechanisms, it is hypothesized that mindfulness meditation influences the processing of emotional information and that it could therefore reduce cognitive vulnerability factors that are observed during and after remission of depressive episodes. In this study we investigated the effects of an 8 week MBCT training versus no intervention on the facilitation and inhibition of attention for sad versus happy faces in a group of people with a history of MDD, N = 45. The comparison group consisted of a non-treatment seeking group with a history of MDD, recruited from the community, N = 26. At baseline, we found that formerly depressed patients who applied for MBCT training inhibited attention for positive information, and showed facilitation of attention for negative information. However, the comparison group did not show similar attentional characteristics. After MBCT, participants showed a reduced facilitation of attention for negative information and a reduced inhibition of attention for positive information, which is indicative of open attention towards all emotional information.
Major depressive disorder is a prevalent condition with high relapse rates. There is evidence that cognitive reactivity is an important vulnerability factor for the recurrence of depression. Mindfulness-based interventions are designed to reduce relapse rates, with cognitive reactivity as one of the proposed working mechanisms. In a randomised controlled trial we compared the effect of mindfulness-based cognitive therapy (MBCT) with treatment-as-usual (TAU) on cognitive reactivity in recurrently depressed patients (N = 115). Depressive symptoms, cognitive reactivity, and mindfulness skills were assessed pre and post treatment. Patients in the MBCT group reported a significantly greater reduction in cognitive reactivity than those in the TAU group (d = .51). The reduction of cognitive reactivity appeared to mediate the association between MBCT/TAU and decrease of depressive symptoms, using pre and post scores. The current study provides evidence that MBCT reduces cognitive reactivity and preliminary evidence that cognitive reactivity is a working mechanism of MBCT.
BackgroundThe aim of this study is to examine the efficacy of mindfulness-based cognitive therapy (MBCT) in addition to treatment as usual (TAU) for recurrent depressive patients with and without a current depressive episode.
Method
A randomized, controlled trial comparing MBCT+TAU (n=102) with TAU alone (n=103). The study population consisted of patients with three or more previous depressive episodes. Primary outcome measure was post-treatment depressive symptoms according to the Hamilton Rating Scale for Depression. Secondary outcome measures included the Beck Depression Inventory, rumination, worry and mindfulness skills. Group comparisons were carried out with linear mixed modelling, controlling for intra-group correlations. Additional mediation analyses were performed. Comparisons were made between patients with and without a current depressive episode.
Results
Patients in the MBCT+TAU group reported less depressive symptoms, worry and rumination and increased levels of mindfulness skills compared with patients receiving TAU alone. MBCT resulted in a comparable reduction of depressive symptoms for patients with and without a current depressive episode. Additional analyses suggest that the reduction of depressive symptoms was mediated by decreased levels of rumination and worry.
Conclusions
The study findings suggest that MBCT is as effective for patients with recurrent depression who are currently depressed as for patients who are in remission. Directions towards a better understanding of the mechanisms of action of MBCT are given, although future research is needed to support these hypotheses.