Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: Randomised controlled non-inferiority trial

Huijbers, Marloes J.; Spinhoven, Philip; Spijker, Jan; Ruhé, Henricus G.; Schaik, Digna J. F. van; Oppen, Patricia van; Nolen, Willem A.; Ormel, Johan; Kuyken, Willem; Wilt, Gert Jan van der; Blom, Marc; Schene, Aart H.; Donders, A. Rogier T.; Speckens, Anne E. M.

doi:10.1192/bjp.bp.115.168971

Cited by 52 publications

(86 citation statements)

References 34 publications

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“…No comparable studies had been conducted previously, except for studies on depression, where the effect of a psychological (mindfulness) intervention after stopping AD was inconclusive [5, 6]. Our finding may be partly due to the timing of the CBT, i.e., simultaneously with the discontinuation period, while most recurrences occurred in the period after tapering.…”

mentioning

confidence: 59%

The Efficacy of a Group CBT Relapse Prevention Program for Remitted Anxiety Disorder Patients Who Discontinue Antidepressant Medication: A Randomized Controlled Trial

Scholten¹,

Batelaan²,

Oppen³

et al. 2018

Psychother Psychosom

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mentioning

confidence: 59%

The Efficacy of a Group CBT Relapse Prevention Program for Remitted Anxiety Disorder Patients Who Discontinue Antidepressant Medication: A Randomized Controlled Trial

Scholten¹,

Batelaan²,

Oppen³

et al. 2018

Psychother Psychosom

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“…with discontinuation of medication (Huijbers et al 2016). MBCT was largely based on the protocol by Segal et al (2002b) with some minor adaptations: it consisted of eight weekly sessions of 2.5 (rather than 2) h and included 1 day of silent practice between the sixth and seventh sessions, which originates from the MBSR curriculum (Jon Kabat-Zinn 2013) and is suggested in the most recent version of the MBCT protocol (Segal et al 2012).…”

Section: Methodsmentioning

confidence: 99%

Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome

et al. 2017

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As mindfulness-based cognitive therapy (MBCT) becomes an increasingly mainstream approach for recurrent depression, there is a growing need for practitioners who are able to teach MBCT. The requirements for being competent as a mindfulness-based teacher include personal meditation practice and at least a year of additional professional training. This study is the first to investigate the relationship between MBCT teacher competence and several key dimensions of MBCT treatment outcomes. Patients with recurrent depression in remission (N = 241) participated in a multi-centre trial of MBCT, provided by 15 teachers. Teacher competence was assessed using the Mindfulness-Based Interventions: Teaching Assessment Criteria (MBI:TAC) based on two to four randomly selected video-recorded sessions of each of the 15 teachers, evaluated by 16 trained assessors. Results showed that teacher competence was not significantly associated with adherence (number of MBCT sessions attended), possible mechanisms of change (rumination, cognitive reactivity, mindfulness, and self-compassion), or key outcomes (depressive symptoms at post treatment and depressive relapse/recurrence during the 15-month follow-up). Thus, findings from the current study indicate no robust effects of teacher competence, as measured by the MBI:TAC, on possible mediators and outcome variables in MBCT for recurrent depression. Possible explanations are the standardized delivery of MBCT, the strong emphasis on self-reliance within the MBCT learning process, the importance of participant-related factors, the difficulties in assessing teacher competence, the absence of main treatment effects in terms of reducing depressive symptoms, and the relatively small selection of videotapes. Further work is required to systematically investigate these explanations.

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“…Furthermore, these MBCT benefits seem to be most pronounced among those at the greatest risk for relapse, such as among individuals with 4 or more previous major depressive episodes (Ma & Teasdale 2004) or among individuals who suffered from maltreatment during childhood (Ma & Teasdale 2004, Williams et al 2014). Many at-risk individuals prefer not to use antidepressant medications (e.g., during pregnancy or to avoid side effect symptoms), and two RCTs indicate that MBCT (with a 4 week taper off antidepressant medications during the 8-week program) has depression relapse prevention benefits on par with maintenance antidepressant medication treatments during 18-24 month follow-up periods (Kuyken et al 2015, Segal et al 2010; although a recent trial suggests that the combination of MBCT plus maintenance antidepressant medication is optimal (Huijbers et al 2016).…”

Section: Mental Healthmentioning

confidence: 99%

Mindfulness Interventions

Creswell

2017

Annu. Rev. Psychol.

1,082

878

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Mindfulness interventions aim to foster greater attention to and awareness of present moment experience. There has been a dramatic increase in randomized controlled trials (RCTs) of mindfulness interventions over the past two decades. This article evaluates the growing evidence of mindfulness intervention RCTs by reviewing and discussing (a) the effects of mindfulness interventions on health, cognitive, affective, and interpersonal outcomes; (b) evidence-based applications of mindfulness interventions to new settings and populations (e.g., the workplace, military, schools); (c) psychological and neurobiological mechanisms of mindfulness interventions; (d) mindfulness intervention dosing considerations; and (e) potential risks of mindfulness interventions. Methodologically rigorous RCTs have demonstrated that mindfulness interventions improve outcomes in multiple domains (e.g., chronic pain, depression relapse, addiction). Discussion focuses on opportunities and challenges for mindfulness intervention research and on community applications.

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Discontinuation of antidepressant medication after mindfulness-based cognitive therapy for recurrent depression: Randomised controlled non-inferiority trial

Cited by 52 publications

References 34 publications

The Efficacy of a Group CBT Relapse Prevention Program for Remitted Anxiety Disorder Patients Who Discontinue Antidepressant Medication: A Randomized Controlled Trial

The Efficacy of a Group CBT Relapse Prevention Program for Remitted Anxiety Disorder Patients Who Discontinue Antidepressant Medication: A Randomized Controlled Trial

Teacher Competence in Mindfulness-Based Cognitive Therapy for Depression and Its Relation to Treatment Outcome

Mindfulness Interventions

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