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

Abstract

Purpose of review This article reviews the recent evidence for mindfulness based cognitive therapy (MBCT) for patients with residual depressive symptoms or in remitted patients at increased risk for relapse. Recent findings Randomized controlled trials have shifted focus from comparing MBCT with treatment-as-usual to comparing MBCT against interventions. These studies have provided evidence for the efficacy of MBCT on par with maintenance antidepressant pharmacotherapy and leading to a relative reduction of risk on the order of 30–40%. Perhaps fuelled by these data, recent efforts have focused on extending MBCT to novel populations, such as acutely depressed patients, those diagnosed with health anxiety, social anxiety, fibromyalgia, or multiple chemical sensitivities as well migrating MBCT to online platforms so that it is more widely available. Neuroimaging studies of patients in structured therapies which feature mindfulness meditation, have reported findings that parallel behavioural changes, such as increased activation in brain regions subsuming self-focus and emotion regulation (prefrontal cortex) and interoceptive awareness (insula). Summary The current evidence base for MBCT is strongest for its application as a prophylactic intervention or for residual depressive symptoms, with early data suggesting additional indications outside the mood disorders. Future work will need to address dose-effect relationships between mindfulness practice and clinical benefits as well as establishing the rates of uptake for online MBCT so that its benefits can be compared to in-person groups. Additionally, validating current or novel neural markers of MBCT treatment response will allow for patient matching and optimization of treatment response.

Dynamic neural activity during stress signals resilient coping

“…a strategy for increasing perceived and behavioral control over stress, pain, depression, and other stress-related conditions (41,42). Along with stress-related VmPFC plasticity, we found the ventral striatum to increase during late relative to early runs in the stress versus neutral contrast, consistent with its role in avoidant learning and motivation (43,44).…”

Distinct Insular Functional Connectivity Changes Related to Mood and Fatigue Improvements in Major Depressive Disorder Following Tai Chi Training: A Pilot Study

“…A recent systematic review of meditative movement practices found significant impact on depression severity (Zou et al, 2018). The therapeutic effects of meditative movement on affective disorders, such as depression and anxiety, seem to be related to the cultivation of awareness of internal bodily sensations (i.e., body awareness; Payne and Crane-Godreau, 2013), similar to findings with standard seated meditation studies (Segal et al, 2010;Segal and Walsh, 2016). Recent studies have begun to identify important subjective and physiological aspects of this body-awareness mechanism that are particularly relevant to an improved sense of vitality in MDD (Payne and Crane-Godreau, 2013).…”

Does Mindfulness‐Based Cognitive Therapy for Migraine Reduce Migraine‐Related Disability in People with Episodic and Chronic Migraine? A Phase 2b Pilot Randomized Clinical Trial

“…It was originally developed to prevent depression relapse [25][26][27] and has been modified to address a variety of chronically painful conditions. It was originally developed to prevent depression relapse [25][26][27] and has been modified to address a variety of chronically painful conditions.…”

“…Mindfulness-Based Cognitive Therapy (MBCT) teaches mindfulness meditation and cognitivebehavioral coping skills and directly applies these skills to address disease-related cognitions and coping. It was originally developed to prevent depression relapse [25][26][27] and has been modified to address a variety of chronically painful conditions. 28 MBCT targets maladaptive disease-related beliefs in addition to stress reduction and is traditionally delivered using a group format with groups of 8-10 individuals.…”