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Lynchburg Journal of Medical Science

Lynchburg Journal of Medical Science

Specialty

Psychiatry

Advisor

Professor Dr. Thomas Colletti, DHSc, MPAS, PA-C

Abstract

Mindfulness-based cognitive therapy (MBCT) was developed as an intervention intended to improve the psychological health of patients at risk for depressive relapse. The mechanism of change for this intervention and its theoretical basis is through cognitive restructuring. Mindfulness-based cognitive therapy is an integration of Cognitive-behavioral therapy and Mindfulness-based stress reduction. Decreasing negative thought patterns and increasing metacognitive awareness are the objectives of therapy.

The purpose of this review is to examine the efficacy of mindfulness-based cognitive therapy for depressive relapse as it is compared to antidepressants and active control conditions (ACC). A literature search for high-quality studies, of level 2 evidence or higher, was performed comparing mindfulness meditation with antidepressants and active control conditions as an intervention for depressive relapse. Fifty-two studies were retrieved. Of the fifty-two, twelve relevant studies were reviewed. Five of the twelve studies directly compared the effectiveness of MBCT to antidepressants, including one systematic review and one meta-analysis. These studies all report the superiority of MBCT to antidepressants for decreasing relapse rates in major depressive patients. The remaining seven studies compared MBCT to carefully designed ACCs. Mixed findings were demonstrated among the ACC groups.

Overall, mindfulness-based cognitive therapy demonstrated efficacy in reducing depressive relapse/recurrence in the smaller studies of both the antidepressant and ACC assessments. Nevertheless, questions remain around effectiveness in larger population trials, its longer-term outcomes, and suitability in combination with medication.

This appraisal will define major depressive disorder, MBCT, discuss relapse trends and pharmacotherapy. In addition, it will present neuro-scientific discoveries and provide an overview of the findings of MBCT’s current research. Lastly, challenges surrounding therapy aspects are identified and discussed.

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