By John M. de Castro, Ph.D.
“Mindfulness-Based Cognitive Therapy (MBCT) is designed to help people who suffer repeated bouts of depression and chronic unhappiness. It combines the ideas of cognitive therapy with meditative practices and attitudes based on the cultivation of mindfulness. The heart of this work lies in becoming acquainted with the modes of mind that often characterize mood disorders while simultaneously learning to develop a new relationship to them.” – MBCT.com
About one out of every five people suffers from a mental disorder. In the U.S. that amounts to over 44 million people. For the U.S. adults about 1.1% live with schizophrenia, 2.6% with bipolar disorder. 6.9% with major depression, 18.1% with anxiety disorders, and 3% with substance use disorders. This places a tremendous burden on the individual, their families, and the health care system. Obviously there is a critical need to find safe, effective, and affordable treatments for these disorders.
Mindfulness training has been shown to be helpful in treating many of these disorders, including schizophrenia, depression, anxiety, and substance abuse. One form of therapy that includes mindfulness training is Mindfulness-Based Cognitive Therapy (MBCT). It was developed specifically to treat depression and has been found to reduce depression alone or in combination with antidepressive drugs. MBCT involves mindfulness training, containing sitting and walking meditation and body scan, and cognitive therapy to alter how the patient relates to the thought processes that often underlie and exacerbate depression. It has proved so effective for depression that it has also begun to be applied to a variety of other mental disorders.
In today’s Research News article “Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials..” See:
or see summary below or view the full text of the study at:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/
Galante and colleagues review the published research literature on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for a variety of mental disorders. They found 11 published randomized controlled trials 10 of which compared MBCT to treatment as usual. There were only a sufficient number of studies to perform a meta-analysis for depression, depression relapse rates, and anxiety. They found that overall the research has demonstrated significant treatment effects for MBCT for the reduction in anxiety and depression. Importantly, MBCT had long-term beneficial effects as evidenced by a significant lowering of the relapse rates from depression on average by 40%.
These are important findings that strongly support the application of MBCT for the treatment of depression and anxiety disorders. The effects were not only robust but lasting, still being significantly better then treatment as usual a year after the end of treatment. It is unfortunate that there were not a greater number of studies of the effectiveness of MBCT for other mental disorders. This underscores the need for more research into the application of MBCT to disorders other than anxiety and depression. It has such powerful and lasting effects on anxiety and depression that it would be predicted that it would also be effective for other disorders.
It is not known exactly how MBCT relieves anxiety and depression. But, it can be speculated that MBCT, by shifting attention away from the past or future to the present moment, interrupts the kinds of thinking that are characteristic of and support anxiety and depression. These include rumination about past events, worry about future events, and catastrophizing about potential future events. Mindfulness has been shown to interrupt rumination, worry, and catastrophizing and focus the individual on what is transpiring in the present. By interrupting these forms of thinking that support anxiety and depression, shifting attention to the present moment where situations are actually manageable, mindfulness may disrupt depression. MBCT also improves the ability to see thoughts as objects of awareness and not something personal. This may be the most important change to improve anxiety and depression. This changes the relationship of the patients with their thoughts, making them less personal and thereby easier to cope with and change.
So, improve mental health with mindfulness.
“People at risk for depression are dealing with a lot of negative thoughts, feelings and beliefs about themselves and this can easily slide into a depressive relapse MBCT helps them to recognize that’s happening, engage with it in a different way and respond to it with equanimity and compassion.” – Willem Kuyken
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Galante, J., Iribarren, S. J., & Pearce, P. F. (2013). Effects of mindfulness-based cognitive therapy on mental disorders: a systematic review and meta-analysis of randomised controlled trials. Journal of Research in Nursing : JRN, 18(2), 133–155. http://doi.org/10.1177/1744987112466087
Key points for policy, practice and research
- Patients with recurrent depression (three episodes or more) treated with additive MBCT have on average 40% fewer relapses at one year of follow-up compared to patients undergoing treatment as usual.
- Improvements in depression and anxiety with additive MBCT were significant at one year of follow-up but unstable in sensitivity analyses.
- More studies with active control groups and long-term follow-ups are needed to better understand the specific effects of MBCT.
- Depression is a symptom that is present in many conditions. More high quality RCTs are needed to evaluate MBCT in populations with varying depression severity as well as diagnosis with multiple co-morbidities.
Abstract
Objective: Mindfulness-based cognitive therapy (MBCT) is a programme developed to prevent depression relapse, but has been applied for other disorders. Our objective was to systematically review and meta-analyse the evidence on the effectiveness and safety of MBCT for the treatment of mental disorders.
Methods: Searches were completed in CENTRAL, MEDLINE, EMBASE, LILACS, PsychINFO, and PsycEXTRA in March 2011 using a search strategy with the terms ‘mindfulness-based cognitive therapy’, ‘mindfulness’, and ‘randomised controlled trials’ without time restrictions. Selection criteria of having a randomised controlled trial design, including patients diagnosed with mental disorders, using MBCT according to the authors who developed MBCT and providing outcomes that included changes in mental health were used to assess 608 reports. Two reviewers applied the pre-determined selection criteria and extracted the data into structured tables. Meta-analyses and sensitivity analyses were completed.
Results:Eleven studies were included. Most of them evaluated depression and compared additive MBCT against usual treatment. After 1 year of follow-up MBCT reduced the rate of relapse in patients with three or more previous episodes of depression by 40% (5 studies, relative risk [95% confidence interval]: 0.61 [0.48, 0.79]). Other meta-analysed outcomes were depression and anxiety, both with significant results but unstable in sensitivity analyses. Methodological quality of the reports was moderate.
Conclusion: Based on this review and meta-analyses, MBCT is an effective intervention for patients with three or more previous episodes of major depression.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5030069/