Mindfulness based cognitive therapy as maintenance treatment for unipolar major depression
- Zindel Segal, PhD, C.Psych
Zindel Segal, PhD, C.Psych
- Professor of Psychiatry
- University of Toronto
Mindfulness based cognitive therapy is a group program that is generally used to delay or prevent recurrence of major depression , but may also reduce depressive symptoms . The treatment combines the clinical application of mindfulness meditation with elements of cognitive-behavioral therapy, and was first developed in 2000 [3-5].
A systematic review of 23 controlled or case-controlled studies found that mindfulness meditation may enhance attention, memory, and some executive functions . Neuroimaging studies have found that meditation may possibly be associated with functional and structural brain changes in areas involved with attention, emotional regulation, and self awareness [7,8], but the clinical significance of these preliminary findings are unknown.
This topic reviews the use of mindfulness based cognitive therapy for the maintenance treatment of patients with recurrent unipolar depression. The initial treatment of depression and treatment of resistant depression are discussed separately. (See "Unipolar major depression in adults: Choosing initial treatment" and "Unipolar depression in adults: Treatment of resistant depression".)
Mindfulness based cognitive therapy is indicated for:
●Maintenance treatment of euthymic patients who have suffered multiple episodes of unipolar major depression – The evidence suggests that the therapy is effective for patients with a history of at least three episodes; the therapy can be used alone or in conjunction with pharmacotherapy. Treatment guidelines from both the United Kingdom National Institute for Health and Clinical Excellence and the Canadian Network for Mood and Anxiety Treatments recommend mindfulness-based cognitive therapy for maintenance treatment of major depressive disorder. In addition, practice guidelines from the American Psychiatric Association suggest that mindfulness-based cognitive therapy can reduce recurrences of depression. (See 'Preventing recurrences' below.)
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- Mindfulness-Based Cognitive Therapy http://www.mbct.com/ (Accessed on April 07, 2011).
- THEORETICAL FOUNDATION
- DELIVERING MINDFULNESS BASED COGNITIVE THERAPY
- Clinician training
- Combined with pharmacotherapy
- Therapeutic interventions
- Managing clinical deterioration
- CONTINUING CARE
- EVIDENCE OF EFFICACY
- Preventing recurrences
- - Mindfulness based cognitive therapy alone compared with pharmacotherapy alone
- - Mindfulness based cognitive therapy plus treatment as usual compared with treatment as usual alone
- Mindfulness based cognitive therapy plus pharmacotherapy
- Acute major depression
- Resolving residual symptoms
- INFORMATION FOR PATIENTS