Mindfulness therapy works for recurrent depression

For people with recurring depression, mindfulness-based cognitive therapy may be more helpful than other treatments, according to a new analysis.

Cognitive therapy focuses on substituting constructive patterns of thinking for maladaptive thought processes. Mindfulness meditation focuses on being aware of incoming thoughts and feelings and accepting them without reacting to them.

Combining mindfulness techniques with cognitive therapy should be an option for patients, according to study leader Willem Kuyken of the University of Oxford in the UK.

"It is about choice for patients and adding another choice for people at high risk of depressive relapse to stay well in the long-term," Kuyken told Reuters Health in an email.

"When mindfulness is combined with cognitive therapy, one of the things we see is people being trained to regard their thoughts as just thoughts and not to get ensnared by them," said Richard Davidson, who wrote an editorial accompanying the study.

The research team analyzed data on 1,258 participants from nine randomized controlled trials that compared mindfulness-based cognitive therapy (MBCT) to other treatments for recurring depression among people who were fully or partially in remission.

Overall, people receiving MBCT were about 31 percent less likely to have depression again after 60 weeks, compared to people who received other treatments, including self help.

After excluding self help, the researchers found that people who received MBCT were still 21 percent less likely to have depression again after 60 weeks, compared to people on other treatments.

MBCT worked equally well regardless of age, sex, education, relationship status, age at onset of depression and previous episodes.

However, in people with more severe depressive symptoms, MBCT worked especially well, compared to other treatments.

"Depression is a recurrent illness," said Davidson, of the Center for Healthy Minds at the University of Wisconsin-Madison. "Relapse is a very significant problem with depression, and mindfulness-based cognitive therapy may be particularly valuable in reducing the risk of relapse."

The researchers write in JAMA Psychiatry April 27 that MBCT teaches skills that help people with recurrent depression to stay well.

Davidson said there is no one-size-fits-all approach to depression. MBCT may be a good choice for some people, but not all.

"We need to better understand it and that's one of the important tasks of future research," he told Reuters Health.

JAMA Psychiatry 2016.