Depression

Mindfulness-Based Cognitive Therapy (MBCT) Plus Loving-Kindness Mediation is highly Effective in Depressed Patients

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Mindfulness-Based Cognitive Therapy (MBCT) Plus Loving-Kindness Mediation is highly Effective in Depressed Patients

 

By John M. de Castro, Ph.D.

 

“MBCT can provide a viable relapse prevention intervention for people with a history of recurrent depression.” – Catherine Crane

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs, only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms). So, it is important that other treatments be identified that can relieve the suffering.

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that attempts to teach patients to distinguish between thoughts, emotions, physical sensations, and behaviors, and to recognize irrational thinking styles and how they affect behavior. MBCT has been found to be effective in treating depression.

 

Loving Kindness Meditation (LKM) is designed to develop kindness and compassion to oneself and others. The individual systematically pictures different individuals from self, to close friends, to enemies and wishes them happiness, well-being, safety, peace, and ease of well-being. Although LKM has been practiced for centuries, it has received very little scientific research attention. But it may be effective in counteracting the effects of stress and self-criticism. It is not known how effective the combination of Mindfulness-Based Cognitive Therapy (MBCT) and Loving Kindness Meditation might be in treating depression.

 

In today’s Research News article “A study on the effects of mindfulness-based cognitive therapy and loving-kindness mediation on depression, rumination, mindfulness level and quality of life in depressed patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205847/ ) Wang and colleagues recruited adult patients with depression and randomly assigned them to receive either regular care or to receive 1 hour once per day for 1 week Loving Kindness Meditation followed by 8 weeks, once per week of Mindfulness-Based Cognitive Therapy (MBCT) also with Loving Kindness Meditation practice. Regular care consisted of “basic knowledge of depression, common drugs, possible adverse drug reactions, and prevention of adverse reactions . . . Face-to-face communication with patients was conducted regularly to understand their thoughts, evaluate the depression degrees of patients, so as to provide psychological support for depressed patients, and care for patients in daily life.” They were measured at baseline and at 2, 4, 6, and 8 weeks for mindfulness, depression, rumination, quality of life, self-acceptance, and sense of stigma.

 

They found that both groups significantly decreased in depression, sense of stigma, and rumination and increased in mindfulness, self-acceptance and quality of life over the 8 weeks. But the intervention group improved significantly more than the control group on all measures.

 

Previous research has shown that mindfulness training produces significant decreases in depression and rumination and increases in self-acceptance and quality of life. What is new here is that they found that the combination of Mindfulness-Based Cognitive Therapy (MBCT) and Loving Kindness Meditation was significantly more effective than the conventional psychological intervention. This is important but must be followed up to see if the improvements in the patients with depression are sustained over longer periods of time.

 

So, Mindfulness-Based Cognitive Therapy (MBCT) plus Loving-Kindness Mediation is highly effective in depressed patients.

 

“MBCT leads to a decrease in depressive symptoms, reduction in depression relapse rate and improvement in terms of mindfulness.” – Zulkiflu ArgunguMusa

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wang, Y., Fu, C., Liu, Y., Li, D., Wang, C., Sun, R., & Song, Y. (2021). A study on the effects of mindfulness-based cognitive therapy and loving-kindness mediation on depression, rumination, mindfulness level and quality of life in depressed patients. American journal of translational research, 13(5), 4666–4675.

 

Abstract

Objective: To analyze the effects of mindfulness-based cognitive therapy (MBCT) plus loving-kindness mediation (LKM) in depressed patients. Methods: A total of 125 depressed patients diagnosed in the Department of Psychiatry of our hospital were selected as the research subjects and were randomly divided into a control group (n=62) and an observation group (n=63). The control group was treated with conventional psychological intervention, while the observation group was treated with MBCT plus LKM. The therapeutic outcomes were compared between the two groups. Results: At 2, 4, 6 and 8 weeks after intervention, the Hamilton Depression Rating Scale (HAMD) scores and the scores for introspection and deliberation, forced thinking, rumination of symptoms, treatment, ability and social relationships in the observation group were lower than those in the control group, while Five Facet Mindfulness Questionnaire (FFMQ) scores and the scores for psychology, environment, physiology, social relations, self-acceptance, and self-evaluation in the observation group were higher than those in the control group (P < 0.05). Conclusion: MBCT plus LKM can effectively improve depression, rumination, mindfulness level, quality of life, the sense of stigma and degree of self-acceptance in depressed patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8205847/

 

Improve Major Depression with Yoga

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Improve Major Depression with Yoga

 

By John M. de Castro, Ph.D.

 

“Kriya yoga may be an effective, low-cost, non-drug approach to help patients who do not respond to antidepressants.” – Anup Sharma

 

Depression affects over 6% of the population. Depression can be difficult to treat. It is usually treated with antidepressant medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering.

 

Mindfulness training is an alternative treatment for depression. It has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.  Another effective alternative treatment is exercise. But it is difficult to get depressed people, who lack energy, to engage in regular exercise. Yoga is a contemplative practice that is both a mindfulness practice and an exercise. It has been shown to be effective in the treatment of depression. So, it makes sense to further study the effectiveness of yoga for major depression.

 

In today’s Research News article “Kriya Yoga in Patients with Depressive Disorders: A Pilot Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079176/) Srivastava and colleagues recruited adult patients with major depressive disorder who were taking psychotropic medications and offered them Kriya yoga therapy. Those who chose not to participate were assigned to the control condition. Kriya yoga consisted of poses, breathing exercises, chanting, mantra repetition, meditation, and relaxation. For the first 2 weeks they were provided daily 45-minute instruction and practice followed by 6 weeks of 20-minute daily home practice. They were measured before training and at 2, 4, 6, and 8 weeks for depression characteristics and their level of depression.

 

They found that in comparison to baseline and the control condition, the participants who practiced Kriya yoga had significantly greater decreases in depression at 2, 4, 6, and 8 weeks. All of the participants in the Kriya yoga group achieved remission by 4 weeks while only 24% of the control group did.

 

The results must be interpreted carefully as the participants were not randomly assigned but rather self-selected to practice yoga or not and there was no follow-up after the completion of training to ascertain if the benefits last beyond the training period. Nevertheless, the participants that selected Kriya yoga in addition to psychotropic medication had faster and greater recovery from their major depressive disorder than participants taking psychotropic medications alone. These are encouraging results and should be followed up with a randomized controlled trial with long-term follow-up.

 

So, improve major depression with yoga.

 

“A breathing-based meditation practice known as Sudarshan Kriya yoga helped alleviate severe depression in people who did not fully respond to antidepressant treatments.” – Science Daily

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Srivastava, A., Kuppili, P. P., Gupta, T., Nebhinani, N., & Chandani, A. (2021). Kriya Yoga in Patients with Depressive Disorders: A Pilot Study. Journal of neurosciences in rural practice, 12(2), 362–367. https://doi.org/10.1055/s-0041-1726618

 

Abstract

Background and Objectives  Despite the easy acceptability and holistic nature of Kriya yoga, there are no studies evaluating the role of Kriya yoga intervention on depression. The objective of the current study was to assess the feasibility and effect of adjunctive Kriya yoga on depression.

Methods  Patients with major depressive disorder who opted for Kriya yoga were recruited into the intervention group (adjunctive Kriya yoga) and those on psychotropic medication alone were enrolled into the control group. The Hamilton Depression Rating Scale (HDRS) measurements were recorded at baseline, end of 2, 4, and 8 weeks.

Results  HDRS scores of the intervention group ( n = 29) were found to be significantly lesser than that of the control group ( n = 52) by the end of 2, 4, and 8 weeks. The remission rate was also significantly greater in the intervention group.

Conclusion  Kriya yoga intervention was found to be feasible, as well as improved the severity of depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8079176/

Spirituality is Associated with Fewer Suicide Attempts

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Spirituality is Associated with Fewer Suicide Attempts

 

By John M. de Castro, Ph.D.

 

“spirituality can engender the perspective that things happen for some reason and serve a greater purpose. This, in turn, deploys our attention toward the potential for a brighter future, which can create a sense of optimism even when one’s situation seems dire.” – David Rosmarin

 

Around 43,000 people take their own lives each year in the US. Someone dies from suicide every 12.3 minutes. Worldwide over 800,000 people die by suicide every year. The problem is far worse than these statistics suggest as it has been estimated that for every completed suicide there were 12 unsuccessful attempts. In other words, about a half a million people in the U.S. attempt suicide each year. Yet compared with other life-threatening conditions there has been scant research on how to identify potential suicide attempters, intervene, and reduce suicidality.

 

Depression and other mood disorders are the number-one risk factor for suicide. More than 90% of people who kill themselves have a mental disorder, whether depression, bipolar disorder or some other diagnosis. So, the best way to prevent suicide may be to treat the underlying cause. For many this means treating depression. Spirituality may help to provide meaning and prevent suicide. But there is scant research on the relationship of spirituality and religiosity and suicide.

 

In today’s Research News article “Factors Related to Suicide Attempts: The Roles of Childhood Abuse and Spirituality.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044867/ ) Tae and Chae recruited patients with anxiety or depressive disorders and had them complete measures of suicide attempts, anxiety, depression, childhood trauma, spiritual well-being, and social support. 25% of the participants indicated that they had attempted suicide.

 

They found that in comparison to non-suicide attempters, the participants who had attempted suicide had significantly higher levels of anxiety, depression, emotional, physical, and sexual abuse, and emotional and physical neglect and significantly lower levels of spirituality and social support. A hierarchal regression revealed that a high level of emotional abuse and a high level of sexual abuse as well as low spirituality predicted suicide attempts. A mediation analysis revealed that childhood emotional, sexual abuse, and low spirituality were all significant direct predictors of suicide attempts and also significant indirect predictors such that abuse and low spirituality were associated with higher levels of depression which, in turn was associated with suicide attempts.

 

These results are correlational. So, no conclusions concerning causation can be reached. But the associations are clear. Depression, childhood emotional and sexual abuse, and low spirituality are all associated with suicide attempts. It is also clear that in addition to being directly associated with suicide attempts, childhood emotional and sexual abuse, and low spirituality also are associated with higher levels of depression which, in turn, is associated with suicide attempts.

 

Childhood emotional and sexual abuse are clearly risk factors for suicide and should be viewed as red flags in evaluating a patient. But these abuses occurred in the past and cannot be changed. Spirituality on the other hand can change. There are many religious and contemplative practices that can improve spirituality. The present results suggest that this may be helpful and lowering depression and preventing suicide. Future research is needed to investigate this idea, that increasing spirituality can decrease suicide risk.

 

So, spirituality is associated with fewer suicide attempts.

 

“I personally think spirituality is a part of each of our beings. It has been the difference in my life and has walked me back from the place where I thought suicide was my only option.” – Kelli Evans

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Tae, H., & Chae, J. H. (2021). Factors Related to Suicide Attempts: The Roles of Childhood Abuse and Spirituality. Frontiers in psychiatry, 12, 565358. https://doi.org/10.3389/fpsyt.2021.565358

 

Abstract

Objectives: The purpose of this article was to identify independent factors associated with suicide attempts in patients with depression and/or anxiety.

Background and Aims: This study was conducted in order to examine whether risk and protective psychological factors influence the risk of suicide attempts among outpatients with anxiety and/or depressive disorders. In this regard, explanatory models have been reported to detect high-risk groups for suicide attempt. We also examined whether identified factors serve as mediators on suicide attempts.

Materials and Methods: Patients from 18 to 65 years old from an outpatient clinic at Seoul St. Mary’s Hospital were invited to join clinical studies. From September 2010 to November 2017, a total of 737 participants were included in the final sample. The Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Childhood Trauma Questionnaire (CTQ), Functional Assessment of Chronic Illness Therapy-Spiritual Well-being Scale (FACIT-Sp-12), and Functional Social Support Questionnaire (FSSQ) were used to assess psychiatric symptoms. An independent samples t-test, a chi-square test, hierarchical multiple regression analyses, and the Baron and Kenny’s procedures were performed in order to analyze data.

Results: Young age, childhood history of emotional and sexual abuse, depression, and a low level of spirituality were significant independent factors for increased suicide attempts. Depression was reported to mediate the relationship between childhood emotional and sexual abuse, spirituality, and suicide attempts.

Conclusions: Identifying the factors that significantly affect suicidality may be important for establishing effective plans of suicide prevention. Strategic assessments and interventions aimed at decreasing depression and supporting spirituality may be valuable for suicide prevention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8044867/

 

Improve the Psychological Well-Being of Medical Students with Mindfulness

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Improve the Psychological Well-Being of Medical Students with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Medical students are being trained to have 100 things on their mind at all times. It’s harder and harder to focus on one thing explicitly. [Mindfulness] gives you that skill to know that you can focus on everything at once, but when you need to focus on one thing, you can be present with it.” – Chloe Zimmerman

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. Currently, over a third of healthcare workers report that they are looking for a new job. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system as it contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Contemplative practices have been shown to reduce the psychological and physiological responses to stress. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep. It would be best to provide techniques to combat burnout early in a medical career. Studying medicine can be extremely stressful and many students show distress and express burnout symptoms. The undergraduate medical student level may be an ideal time to intervene.

 

In today’s Research News article “Mindfulness-based stress reduction for medical students: a narrative review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105581/ )  Polle and colleagues review and summarize the published research on the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program to improve the psychological well-being of undergraduate medical students. MBSR includes training in meditation, body scan, and yoga, and group discussions normally over an 8-week period. They identified 9 published studies.

 

They report that the published research found that Mindfulness-Based Stress Reduction (MBSR) produced significant increases in undergraduate medical students mood, mental health, satisfaction with life, and self-compassion and significant reductions in psychological distress, perceived stress, and depression. One study followed up these students 6 years later and found persisting effects of MBSR.

 

The published research paints a clear picture that participating in a Mindfulness-Based Stress Reduction (MBSR) program produces lasting benefits for the psychological health of undergraduate medical students. This is important as stress and burnout is prevalent in the medical professions and intervening early may prevent or ameliorate future problems. Incorporation of MBSR into the undergraduate medical curriculum should be considered.

 

So, improve the psychological well-being of medical students with mindfulness.

 

“in medical students, higher empathy, lower anxiety, and fewer depression symptoms have been reported by students after participating in MSBR. In summary, mindfulness meditation may be used to elicit positive emotions, minimize negative affect and rumination, and enable effective emotion regulation.”- Michael Minichiello

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Polle, E., & Gair, J. (2021). Mindfulness-based stress reduction for medical students: a narrative review. Canadian medical education journal, 12(2), e74–e80. https://doi.org/10.36834/cmej.68406

 

Abstract

Background

Medical students are at high risk of depression, distress and burnout, which may adversely affect patient safety. There has been growing interest in mindfulness in medical education to improve medical student well-being. Mindfulness-based stress reduction (MBSR) is a commonly used, standardized format for teaching mindfulness skills. Previous research has suggested that MBSR may be of particular benefit for medical students. This narrative review aims to further investigate the benefits of MBSR for undergraduate medical students.

Methods

A search of the literature was performed using MedLine, Embase, ERIC, PSYCInfo, and CINAHL to identify relevant studies. A total of 102 papers were identified with this search. After review and application of inclusion and exclusion criteria, nine papers were included in the study.

Results

MBSR training for medical students was associated with increased measures of psychological well-being and self-compassion, as well as improvements in stress, psychological distress and mood. Evidence for effect on empathy was mixed, and the single paper measuring burnout showed no effect. Two studies identified qualitative themes which provided context for the quantitative results.

Conclusions

MBSR benefits medical student well-being and decreases medical student psychological distress and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8105581/

 

Improve Psychological Well-Being in Patients with Fever Undergoing Covid-19 Screening with Mindfulness

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Improve Psychological Well-Being in Patients with Fever Undergoing Covid-19 Screening with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness-based approaches appear well-suited to deal with the challenges presented by the time of unpresented uncertainty, change, and loss, which can take many forms in the context of COVID-19 pandemic.” – Elena Antonova

 

Mindfulness training has been shown to improve health and well-being in healthy individuals. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. One of the primary effects of mindfulness that may be responsible for many of its benefits is that it improves the physiological and psychological responses to stress. The COVID-19 pandemic is extremely stressful particularly for patients running a fever and being screened for Covid-19.  So, mindfulness, because of its ability to improve stress responding, may be helpful in coping with the mental challenges of awaiting COVID-19 test results.

 

In today’s Research News article “Using Mindfulness to Reduce Anxiety and Depression of Patients With Fever Undergoing Screening in an Isolation Ward During the COVID-19 Outbreak.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.664964/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1651992_69_Psycho_20210603_arts_A )  Liu and colleagues recruited adult patients who had a fever and were undergoing screening in a hospital for Covid-19. They were randomly assigned either to no-treatment or a very brief (25 minute) mindfulness instruction while awaiting test results. They were measured at the time of admissions and again just before test results for positive and negative emotions, distress, satisfaction with life, anger, anxiety, and depression.

 

They found that in comparison to baseline and the no-treatment controls, the participants who had received brief mindfulness instruction had significantly lower anger, distress, anxiety, depression, and need for help and higher satisfaction with life. Hence, the brief mindfulness instruction improved the mood and psychological well-being of these patients during a very stressful time of awaiting Covid-19 test results.

 

Mindfulness has been previously found to be effective in reducing anger, distress, anxiety, and depression, and increasing satisfaction with life. What the present study demonstrates is that these benefits can occur after a very brief instruction for patients in a very stressful situation. This suggests that brief mindfulness instruction should be incorporated into the routine treatment of patients under high short-term stress.

 

So, improve psychological well-being in patients with fever undergoing Covid-19 screening with mindfulness.

 

“mindfulness is an increasingly accessible intervention available world-wide that may reduce psychological distress during this isolating public health crisis.” – Susan Farris

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Liu Y, Huyang S, Tan H, He Y, Zhou J, Li X, Ye M, Huang J and Wu D (2021) Using Mindfulness to Reduce Anxiety and Depression of Patients With Fever Undergoing Screening in an Isolation Ward During the COVID-19 Outbreak. Front. Psychol. 12:664964. doi: 10.3389/fpsyg.2021.664964

 

The coronavirus disease 2019 (COVID-19) continues to spread globally. This infectious disease affects people not only physically but also psychologically. Therefore, an effective psychological intervention program needs to be developed to improve the psychological condition of patients screened for fever during this period. This study aimed to investigate the effect of a brief mindfulness intervention on patients with suspected fever in a screening isolation ward awaiting results of the COVID-19 test. The Faces Scale and the Emotional Thermometer Tool were used to investigate 51 patients who were randomly divided into an intervention group and a control group. All patients completed self-rating questionnaires online at the time they entered the isolation ward and before they were informed of the results. The intervention group listened to the mindfulness audios through hospital broadcasts in the isolation ward before their lunch break and while they slept. Compared with the control group, the intervention group’s life satisfaction score increased (F = 4.02, p = 0.051) and the emotional thermometer score decreased (F = 8.89, p = 0.005). The anxiety scores (F = 9.63, p = 0.003) and the needing help scores decreased significantly (F = 4.95, p = 0.031). Distress (F = 1.41, p = 0.241), depression (F = 1.93, p = 0.171), and anger (F = 3.14, p = 0.083) also decreased, but did not reach significance. Brief mindfulness interventions can alleviate negative emotions and improve the life satisfaction of patients in the isolation ward who were screened for COVID-19 during the waiting period.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.664964/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1651992_69_Psycho_20210603_arts_A

 

Improve the Psychological Well-Being of Caregivers with Self-Compassion and Mindfulness

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Improve the Psychological Well-Being of Caregivers with Self-Compassion and Mindfulness

 

By John M. de Castro, Ph.D.

 

“Being more aware of our present moment experience also helps with self-care, something that caregivers often overlook. With a mindfulness practice you can notice sooner when you feel tired, or are having an emotional experience, and make sure you stop and look after yourself.” – Naomi Stoll

 

There is a tremendous demand for caregiving in the US. It is estimated that over 65 million (29% of the adult population) provides care to someone who is ill, disabled or aged, averaging 20 hours per week spent caring for their loved ones. This caregiving comes at a cost exacting a tremendous toll on caregivers’ health and well-being. Caregiving has been associated with increased levels of depression and anxiety as well as higher use of psychoactive medications, poorer self-reported physical health, compromised immune function, and increased mortality. Mindfulness practice for caregivers has been shown to help them cope with the physical and psychological demands of caregiving.

 

In today’s Research News article “The Short- and Long-term Causal Relationships Between Self-compassion, Trait Mindfulness, Caregiver Stress, and Depressive Symptoms in Family Caregivers of Patients with Lung Cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8096886/)  Hsieh and colleagues recruited family caregivers of patients diagnosed with non-small cell lung cancer.  To investigate longitudinal changes, they were administered questionnaires initially and 2, 5, and 8 months later. They were measured for mindfulness, depression, perceived stress, and self-compassion.

 

They found that over time depressed caregivers had significant declines in their depression levels. They also found that the higher the levels of mindfulness the lower the levels of depression and perceived stress, and the higher the levels of self-compassion and the higher the levels of depression the lower the levels of self-compassion and the higher the levels of perceived stress. Further they found that over the 4 measurements self-compassion at time 1 was associated with higher mindfulness at time 2 which was associated with lower perceived stress at time 3 which was associated with lower depression at time 4.

 

It has been well established that mindfulness is associated with greater self-compassion and lower stress and depression. The present study found that depression tends to decrease over time associated with self-compassion and mindfulness. In particular self-compassion appears to be important for lowering caregiver depression levels over time and it does so by being associated with higher mindfulness which is associated with lower stress levels which, in turn, are associated with lower depression.

 

The present study is correlational and as such causation cannot be determined. But, in combination with prior manipulative research it can be suggested that training in self-compassion and mindfulness should be very beneficial for caregivers of lung cancer patients lowering their stress and depression.

 

So, improve the psychological well-being of caregivers with self-compassion and mindfulness.

 

“The big open secret is that the key to reducing caregiver burnout and compassion fatigue lies in what can be construed to some as the seemingly counterintuitive wisdom of mindfulness.“ – Audrey Meinertzhagen

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Hsieh, C. C., Lin, Z. Z., Ho, C. C., Yu, C. J., Chen, H. J., Chen, Y. W., & Hsiao, F. H. (2021). The Short- and Long-term Causal Relationships Between Self-compassion, Trait Mindfulness, Caregiver Stress, and Depressive Symptoms in Family Caregivers of Patients with Lung Cancer. Mindfulness, 1–10. Advance online publication. https://doi.org/10.1007/s12671-021-01642-4

 

Abstract

Objectives

Using a prospective longitudinal design, this paper examines a serial mediation model of the associations between self-compassion, trait mindfulness, caregiver stress, and depressive symptoms among the family caregivers of patients with lung cancer.

Methods

A four-wave design was used, with initial assessment (T1) and three follow-ups, at the 2nd month (T2), the 5th month (T3), and the 8th month (T4). A total of 123 family caregivers completed the baseline measurements, including caregiver stress, self-compassion, trait mindfulness, and depressive symptoms. Data were analyzed by serial mediation models to determine the causal ordering of these variables.

Results

Nearly one-quarter of the family caregivers suffered from clinically significant depressive symptoms and the severity of their depression remained unchanged throughout the 8-month follow-up period. Both cross-sectional and longitudinal path analyses revealed that the relationship between self-compassion and depressive symptoms was mediated sequentially by trait mindfulness and caregiver stress. The subscale analysis indicated that the association of higher compassionate action with fewer depressive symptoms was through chain-mediating effects of higher mindful awareness and lower caregiver stress.

Conclusions

Family caregivers who have higher levels of self-compassion tend to have more mindfulness; greater mindfulness leads to lower levels of perceived caregiving stress which, in turn, links to fewer symptoms of depression. Both self-compassion and mindfulness could be regarded as protective factors for caregivers to reduce caregiving stress and depression.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8096886/

 

Improve Depression with Mindfulness-Based Cognitive Therapy (MBCT)

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Improve Depression with Mindfulness-Based Cognitive Therapy (MBCT)

 

By John M. de Castro, Ph.D.

 

“MBCT encourages individuals with [Major Depressive Disorder] to become more aware of their internal events (ie, thoughts, feelings, and bodily sensations) and to change the ways in which they relate to these thoughts. For example, individuals are encouraged to view their thoughts as passing events in the mind, rather than treat them as reality. Disengaging from automatic negative cognitive patterns, such as rumination, reduces the future risk of relapse.” – Meagan MacKenzie

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness training has been shown to be an effective treatment for depression and its recurrence and even in the cases where drugs fail.

 

The most commonly used mindfulness technique for the treatment of depression is Mindfulness-Based Cognitive Therapy (MBCT).  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 psychological symptoms. MBCT has been shown to be as effective as antidepressant drugs in relieving the symptoms of depression and preventing depression reoccurrence and relapse. In addition, it appears to be effective as either a supplement to or a replacement for these drugs. The research has been accumulating. So, it is reasonable to take an overall look at what has been learned.

 

In today’s Research News article “Mindfulness-based cognitive therapy in patients with depression: current perspectives.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018485/ ) MacKenzie and colleagues review and summarize the published research on the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) for depression.

 

They report that the published research studies demonstrate that Mindfulness-Based Cognitive Therapy (MBCT) produces significant decreases in current depression in patients with major depressive disorder and also significantly reduces the reoccurrence of depression in patients in remission. the research also found that MBCT produces these improvements in depression by increasing mindfulness, positive emotions and self-compassion and reducing rumination, negative emotions, and cognitive and emotional reactivity.

 

Hence, the published research has built a compelling case that Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective treatment for depression and its reoccurrence. It does so by altering a number of intermediaries that directly effect depression. MBCT should be recommended as a front-line treatment.

 

So, improve depression with Mindfulness-Based Cognitive Therapy (MBCT).

 

“meta-analyses have demonstrated the efficacy of MBCT for reducing depression symptoms in patients with current depression . . . MBCT has been shown to perform as well as other comparable evidence-based treatments.” – Alice Tickell

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

MacKenzie, M. B., Abbott, K. A., & Kocovski, N. L. (2018). Mindfulness-based cognitive therapy in patients with depression: current perspectives. Neuropsychiatric disease and treatment, 14, 1599–1605. https://doi.org/10.2147/NDT.S160761

 

Abstract

Mindfulness-based cognitive therapy (MBCT) was developed to prevent relapse in individuals with depressive disorders. This widely used intervention has garnered considerable attention and a comprehensive review of current trends is warranted. As such, this review provides an overview of efficacy, mechanisms of action, and concludes with a discussion of dissemination. Results provided strong support for the efficacy of MBCT despite some methodological shortcomings in the reviewed literature. With respect to mechanisms of action, specific elements, such as mindfulness, repetitive negative thinking, self-compassion and affect, and cognitive reactivity have emerged as important mechanisms of change. Finally, despite a lack of widespread MBCT availability outside urban areas, research has shown that self-help variations are promising. Combined with findings that teacher competence may not be a significant predictor of treatment outcome, there are important implications for dissemination. Taken together, this review shows that while MBCT is an effective treatment for depression, continued research in the areas of efficacy, mechanisms of action, and dissemination are recommended.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6018485/

 

Improve Physical and Mental Health with an Isha Yoga Retreat

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Improve Physical and Mental Health with an Isha Yoga Retreat

 

By John M. de Castro, Ph.D.

 

“As we have physical science to create external wellbeing there is a whole inner dimension of science to create inner wellbeing. I call it Inner Engineering.” – Sadhguru

 

Retreat can be a powerful experience. But it can be quite difficult and challenging. It can be very tiring and physically challenging as engaging in sitting meditation repeatedly over the day is guaranteed to produce many aches and pains in the legs, back, and neck. But the real challenges are psychological, emotional, and spiritual. Retreat can be a real test. The darkness can descend. Deep emotional issues can emerge and may even overwhelm the individual. With all these difficulties, why would anyone want to put themselves through such an ordeal and go on a meditation retreat? People go because they find that retreat produces many profound and sometimes life altering benefits.

 

In today’s Research News article “Isha Yoga Practices and Participation in Samyama Program are Associated with Reduced HbA1C and Systemic Inflammation, Improved Lipid Profile, and Short-Term and Sustained Improvement in Mental Health: A Prospective Observational Study of Meditators.” (See summary below or view the full text of the study at: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.659667/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1645362_69_Psycho_20210525_arts_A )   Sadhasivam and colleagues recruited adult participants in a scheduled 8-day Isha yoga retreat and their spouses as controls. Retreat participants had to engage in 2 months of preparatory practices including a vegan diet daily practice of hata yoga, kriya yoga, and Shoonya meditation. In the retreat there was intensive practice. They were measured before, after, and 3-4 months later for depression, anxiety, mindfulness, joy, vitality, and resilience, diet, yoga practice, dietary restrictions, and overall health/well-being. They also had blood drawn and assayed for hemoglobin A1c (HbA1c), hemoglobin (Hb), lipid profile [cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL), and triglycerides (TG)], and C-reactive protein (CRP).

 

They found that after the retreat and sustained 3-4 months later were significant decreased in anxiety and depression and significant increases in mindfulness, joy, vitality, resilience, blood triglycerides, and body weight. These changes did not occur in the control group. Previous research has similarly demonstrated that yoga and meditation decreases anxiety, depression, blood triglycerides and increases joy, vitality, resilience, and body weight.

 

The study did not have a comparable control group and as a result there are a number of possible alternative explanations for the results including participant expectancy effects. To sign up for and engage in an intensive retreat, there was likely a strong belief that the retreat would be beneficial producing a strong expectancy (placebo) effect. Future research should include a comparison to a different kind of retreat or, as has been used in other studies, a comparison to the effects of a comparable duration vacation.

 

The results are interesting in that the participants had considerable practice during the 2-month preparatory phase. So, the effects of the practices would be expected to be present before the retreat began. So, the improvements observed were due to participation in a 4-day intensive retreat rather than the practices themselves. The retreat involves residential living in a group and withdrawal from daily life. This has social effects and vacation-like effects of removal of life stressors. These could be responsible for the observed benefits. This supports the need for future better controlled research.

 

So, improve physical and mental health with an Isha yoga retreat.

 

“An intense 4-day guided Isha meditation retreat significantly decreased depression and anxiety while improving happiness, mindfulness, and psychological well-being.” – Senthilkumar Sadhasivam

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Sadhasivam S, Alankar S, Maturi R, Williams A, Vishnubhotla RV, Hariri S, Mudigonda M, Pawale D, Dubbireddi S, Packiasabapathy S, Castelluccio P, Ram C, Renschler J, Chang T and Subramaniam B (2021) Isha Yoga Practices and Participation in Samyama Program are Associated with Reduced HbA1C and Systemic Inflammation, Improved Lipid Profile, and Short-Term and Sustained Improvement in Mental Health: A Prospective Observational Study of Meditators. Front. Psychol. 12:659667. doi: 10.3389/fpsyg.2021.659667

 

Background: Meditation is gaining recognition as a tool to impact health and well-being. Samyama is an 8-day intensive residential meditation experience conducted by Isha Foundation requiring several months of extensive preparation and vegan diet. The health effects of Samyama have not been previously studied. The objective was to assess physical and emotional well-being before and after Samyama participation by evaluating psychological surveys and objective health biomarkers.

Methods: This was an observational study of 632 adults before and after the Isha Samyama retreat. All participants were invited to complete surveys. Controls included household significant others. Surveys were completed at baseline (T1), just before Samyama (T2), immediately after Samyama (T3), and 3 months later (T4) to assess anxiety, depression, mindfulness, joy, vitality, and resilience through validated psychometric scales. Voluntary blood sampling for biomarker analysis was done to assess hemoglobin (Hb), HbA1c, lipid profile, and C-reactive protein (CRP). Primary outcomes were changes in psychometric scores, body weight, and blood biomarkers.

Results: Depression and anxiety scores decreased from T1 to T3, with the effect most pronounced in participants with baseline depression or anxiety. Scores at T4 remained below baseline for those with pre-existing depression or anxiety. Vitality, resilience, joy, and mindfulness increased from T1 to T3 (sustained at T4). Body weight decreased by 3% from T1 to T3. Triglycerides (TG) were lower from T2 to T3. Participants had lower HbA1c and HDL at T2, and lower CRP at all timepoints compared with controls.

Conclusions: Participation in the Isha Samyama program led to multiple benefits. The 2-month preparation reduced anxiety, and participants maintained lower anxiety levels at 3 months post-retreat. Physical health improved over the course of the program as evidenced by weight loss and improved HbA1C and lipid profile. Practices associated with the Samyama preparation phase and the retreat may serve as an effective way to improve physical and mental health. Future studies may examine their use as an alternative therapy in patients with depression and/or anxiety.

https://www.frontiersin.org/articles/10.3389/fpsyg.2021.659667/full?utm_source=F-AAE&utm_medium=EMLF&utm_campaign=MRK_1645362_69_Psycho_20210525_arts_A

 

Improve the Respiratory Symptoms of Lung Cancer Patients with Qigong Practice

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Improve the Respiratory Symptoms of Lung Cancer Patients with Qigong Practice

 

By John M. de Castro, Ph.D.

 

“Studies show that qigong practice can have many positive effects, particularly among patients with cancer, chronic illnesses, and breathing problems, as well as older adults. Benefits include improved lung function, mood, sleep, and quality of life, as well as reduced stress, pain, anxiety, and fatigue.” – Sloan Kettering Institute

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including stress,  sleep disturbance, and anxiety and depression. Tai Chi or Qigong practice has been shown to improve quality of life, reduce fatigue, and lower blood pressure and cortisol levels. They are very gentle and safe practices. The research on the effectiveness of Qigong training for lung cancer patients is sparse. So, it makes sense to Investigate the ability of Qigong training to improve the symptoms of lung cancer.

 

In today’s Research News article “The Effectiveness of Qigong in Managing a Cluster of Symptoms (Breathlessness-Fatigue-Anxiety) in Patients with Lung Cancer: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047940/ )  Molassiotis and colleagues recruited patients who had complete treatment for lung cancer and randomly assigned them to either a wait-list control group or to engage in Qigong practice. They were trained in Qigong in 2 weekly 90-minute practices for 2 weeks and then practiced Qigong at home for 30 minutes per day, 5 days per week, for 4 weeks. They were measured before and after training and at 12 weeks for disease status, fatigue, dyspnea (difficulty with breathing), anxiety, depression, cough frequency intensity and bothersomeness, and quality of life.

 

They found that in comparison to baseline the group that practiced Qigong had significant reductions in fatigue, dyspnea (difficulty with breathing), anxiety, and cough score that were maintained at the 12-week follow-up. These effects were significantly greater in men than in women. Hence, Qigong practice appeared to improve the symptoms in lung cancer patients.

 

It should be noted that 2 weeks of Qigong training followed by 4 weeks of home practice is a rather low amount of practice relative to what is usually prescribed in other controlled research, as much as 6 months of practice. In addition, only 62% of the Qigong group completed the practice with a 62% adherence rate. So, the effective dose of Qigong was low. This suggests that if practice was extended over longer periods of time greater effectiveness would have been observed. Nevertheless, Qigong practice, even in low dose, had positive benefits for lung cancer patients.

 

So, improve the respiratory symptoms of lung cancer patients with Qigong practice.

 

“Qigong improved physical and mental well-being as well as quality-of-life in patients with lung cancer.” – Patient Power

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Molassiotis, A., Vu, D. V., & Ching, S. (2021). The Effectiveness of Qigong in Managing a Cluster of Symptoms (Breathlessness-Fatigue-Anxiety) in Patients with Lung Cancer: A Randomized Controlled Trial. Integrative cancer therapies, 20, 15347354211008253. https://doi.org/10.1177/15347354211008253

 

Abstract

Background and Purpose:

Qigong is used by cancer patients, but its effect is not adequately evaluated to date. The aim of this study was to investigate the effects of Qigong for the management of a symptom cluster comprising fatigue, dyspnea, and anxiety in patients with lung cancer.

Methodology:

A total of 156 lung cancer patients participated in this trial, and they were randomized to a Qigong group (6 weeks of intervention) or a waitlist control group receiving usual care. The symptom cluster was assessed at baseline, at the end of treatment (primary outcome), and at 12 weeks, alongside measures of cough and quality of life (QOL).

Results:

There was no significant interaction effect between group and time for the symptom cluster overall and for fatigue and anxiety. However, a significant trend towards improvement was observed on fatigue (P = .004), dyspnea (P = .002), and anxiety (P = .049) in the Qigong group from baseline assessment to the end of intervention at the 6th week (within-group changes). Improvements in dyspnea and in the secondary outcomes of cough, global health status, functional well-being and QOL symptom scales were statistically significant between the 2 groups (P = .001, .014, .021, .001, and .002, respectively).

Conclusion:

Qigong did not alleviate the symptom cluster experience. Nevertheless, this intervention was effective in reducing dyspnea and cough, and improving QOL. More than 6 weeks were needed, however, for detecting the effect of Qigong on improving dyspnea. Furthermore, men benefited more than women. It may not be beneficial to use Qigong to manage the symptom cluster consisting of fatigue, dyspnea, and anxiety, but it may be effective in managing respiratory symptoms (secondary outcomes needing further verification in future research). Future studies targeting symptom clusters should ensure the appropriateness of the combination of symptoms.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8047940/

 

Mindfulness is a Cost-Effective Treatment to Prevent Depression Relapse

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Mindfulness is a Cost-Effective Treatment to Prevent Depression Relapse

 

By John M. de Castro, Ph.D.

 

“MBCT significantly reduces the rates of depressive relapse or recurrence compared with usual care or placebo, corresponding to a relative risk reduction of 34%.” – Willem Kuyken

 

Clinically diagnosed depression is the most common mental illness, affecting over 6% of the population. Major depression can be quite debilitating, impairing the ability of the patients to effectively conduct their lives. Depression can be difficult to treat and is usually treated with anti-depressive medication. But, of patients treated initially with drugs only about a third attained remission of the depression. After repeated and varied treatments including drugs, therapy, exercise etc. only about two thirds of patients attained remission. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Even after remission some symptoms of depression may still be present (residual symptoms).

 

Being depressed and not responding to treatment or relapsing is a terribly difficult situation. The patients are suffering and nothing appears to work to relieve their intense depression. Suicide becomes a real possibility. So, it is imperative that other treatments be identified that can relieve the suffering. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression. MBCT involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy that is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms. MBCT has been shown to be effective for the treatment of major depression. But there is little understanding of the cost-effectiveness of MBCT relative to drug treatment. So, it is important to take a serious look at the costs of implementing MBCT and its effectiveness in comparison to the costs and effectiveness of antidepressant pharmacotherapy.

 

In today’s Research News article “Cost-Utility Analysis of Mindfulness-Based Cognitive Therapy Versus Antidepressant Pharmacotherapy for Prevention of Depressive Relapse in a Canadian Context. Canadian journal of psychiatry” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492890/ )  Pahlevan and colleagues reviewed published research studies comparing the cost-effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) versus antidepressant pharmacotherapy for the prevention of relapse in patients with Major Depressive Disorder who had had at least 2 past episodes of major depression.

 

They report that the published research found that over a 2-year period Mindfulness-Based Cognitive Therapy (MBCT) costs $2,224.67 less than antidepressant pharmacotherapy and produces greater gains in quality of life. This greater cost effectiveness of MBCT disappeared when adherence rates were considered. Hence, the greater cost effectiveness of MBCT was due to its ability to motivate greater compliance with the treatment.

 

These results are important as when multiple effective treatments are available, the cost of treatment becomes important. The analysis suggests that Mindfulness-Based Cognitive Therapy (MBCT) not only costs less to deliver but also produces greater benefits. It is interesting that this advantage over antidepressant pharmacotherapy was due to improved compliance and not the superiority of the treatment. But a treatment is only as good as the patient’s adherence to its requirements and MBCT  produces greater adherence.

 

So, mindfulness is a cost-effective treatment to prevent depression relapse.

 

“The rationale behind the MBCT program is based on an empirically supported, theoretical framework suggesting that patients with recurrent depression become more vulnerable to developing depression as cognitive reactivity increases.” – Marloes J Huijbers

 

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Pahlevan, T., Ung, C., & Segal, Z. (2020). Cost-Utility Analysis of Mindfulness-Based Cognitive Therapy Versus Antidepressant Pharmacotherapy for Prevention of Depressive Relapse in a Canadian Context: Analyse coût-utilité de la thérapie cognitive basée sur la pleine conscience contre la pharmacothérapie antidépressive pour prévenir la rechute de la dépression en contexte canadien. Canadian journal of psychiatry. Revue canadienne de psychiatrie, 65(8), 568–576. https://doi.org/10.1177/0706743720904613

 

Abstract

Objective:

Patients suffering from major depressive disorder (MDD) experience impaired functioning and reduced quality of life, including an elevated risk of episode return. MDD is associated with high societal burden due to increased healthcare utilization, productivity losses, and suicide-related costs, making the long-term management of this illness a priority. The purpose of this study is to evaluate the cost-effectiveness of mindfulness-based cognitive therapy (MBCT), a first-line preventative psychological treatment, compared to maintenance antidepressant medication (ADM), the current standard of care.

Method:

A cost–utility analysis was conducted over a 24-month time horizon to model differences between MBCT and ADM in cost and quality-adjusted life years (QALY). The analysis was conducted using a decision tree analytic model. Intervention efficacy, utility, and costing data estimates were derived from published sources and expert consultation.

Results:

MBCT was found to be cost-effective compared to maintenance ADM over a 24-month time horizon. Antidepressant pharmacotherapy resulted in 1.10 QALY and $17,255.37 per patient on average, whereas MBCT resulted in 1.18 QALY and $15,030.70 per patient on average. This resulted in a cost difference of $2,224.67 and a QALY difference of 0.08, in favor of MBCT. Multiple sensitivity analyses supported these findings.

Conclusions:

From both a societal and health system perspective, utilizing MBCT as a first-line relapse prevention treatment is potentially cost-effective in a Canadian setting. Future economic evaluations should consider combined treatment (e.g., ADM and psychotherapy) as a comparator and longer time horizons as the literature advances.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7492890/