A Preliminary Study: Efficacy of Mindfulness-Based Cognitive Therapy versus Sertraline as First-line Treatments for Major Depressive Disorder

Abstract

Major depressive disorder (MDD) is the leading cause of disability in the developed world, yet broadly effective treatments remain elusive. The primary aim of this pilot study was to investigate the efficacy of Mindfulness-Based Cognitive Therapy (MBCT) monotherapy, compared to sertraline monotherapy, for patients with acute MDD. This open-label, nonrandomized controlled trial examined a MBCT cohort (N=23) recruited to match the gender, age, and depression severity of a depressed control group (N=20) that completed 8 weeks of monotherapy with the antidepressant sertraline. The 17-item clinician-rated Hamilton Depression Severity Rating Scale (HAMD-17) was the primary outcome measure of depression to assess overall change after 8 weeks and rates of response and remission. The 16-item Quick Inventory of Depressive Symptomatology-Self-Report (QIDS-SR16) was the secondary outcome measure to further assess depression severity. Both cohorts were demographically similar and showed significant improvement in depression ratings. No difference was found in the degree of change in HAMD-17 scores (t(34) = 1.42, p = .165) between groups. Secondary analysis showed statistically significant differences in mean scores of the QIDS-SR16 (t (32) = 4.39, p < 0.0001), with the MCBT group showing greater mean improvement. This study was limited by the small sample size and non-randomized, non-blinded design. Preliminary findings suggest that an 8-week course of MBCT monotherapy may be effective in treating MDD and a viable alternative to antidepressant medication. Greater changes in the self-rated QIDS-SR16 for the MBCT cohort raise the possibility that patients derive additional subjective benefit from enhanced self-efficacy skills.

The Effectiveness of Mindfulness-Based Cognitive Therapy (MBCT) in Real-World Healthcare Services

“…However, it should be noted that the effect sizes observed are similar to those reported in a study that documented pre-to post-intervention changes in depressive symptoms in patients randomised to MBCT or treatment as usual (van Aalderen et al 2012). Where substantially larger effects have been observed, these have been based on small samples (Barnhofer et al 2009;Chiesa et al 2015;Eisendrath et al 2015;Kingston et al 2007). In the present study, the effect on PHQ-9 symptoms was smaller compared to interventions offered in IAPT services overall for depression cases (1.4; Clark 2018).…”

Mindfulness-based cognitive therapy for residual depressive symptoms and relapse prophylaxis

“…Finally, Eisendrath et al . [21**] present initial data to suggest that MBCT may be an effective first-line treatment in acute depression relative to Sertraline, suggesting MBCT’s value for patients who cannot tolerate side effects or do not respond to an initial trial of antidepressant medication.…”

A Pilot Study of Mindfulness-Based Exposure Therapy in OEF/OIF Combat Veterans with PTSD: Altered Medial Frontal Cortex and Amygdala Responses in Social–Emotional Processing

“…Mindfulness-based interventions, such as mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT), involve training in attention and emotional regulation ( 10 , 11 ) and are delivered in group format. There is accumulating evidence that MBCT and MBSR may be helpful for depression, and anxiety: MBCT has demonstrated effectiveness for relapse prevention in patients with severe, chronic major depressive disorder ( 12 ), and MBSR and MBCT appear useful for depression ( 13 , 14 ) and generalized anxiety disorder (GAD) ( 15 ). Recent studies have suggested that mindfulness training may also be a useful component for treatment of PTSD.…”