Mindfulness-based cognitive therapy reduces depression symptoms in people with a traumatic brain injury: Results from a pilot study

Abstract

Background and Aims:Major depression is a significant problem for people with a traumatic brain injury (TBI) and its treatment remains difficult. A promising approach to treat depression is Mindfulness-based cognitive therapy (MBCT), a relatively new therapeutic approach rooted in mindfulness based stress-reduction (MBSR) and cognitive behavioral therapy (CBT). We conducted this study to examine the effectiveness of MBCT in reducing depression symptoms among people who have a TBI.Methods:Twenty individuals diagnosed with major depression were recruited from a rehabilitation clinic and completed the 8-week MBCT intervention. Instruments used to measure depression symptoms included: BDI-II, PHQ-9, HADS, SF-36 (Mental Health subscale), and SCL-90 (Depression subscale). They were completed at baseline and post-intervention.Results:All instruments indicated a statistically significant reduction in depression symptoms post-intervention (p < .05). For example, the total mean score on the BDI-II decreased from 25.2 (9.8) at baseline to 18.2 (11.7) post-intervention (p=.001). Using a PHQ threshold of 10, the proportion of participants with a diagnosis of major depression was reduced by 59% at follow-up (p=.012).Conclusions:Most participants reported reductions in depression symptoms after the intervention such that many would not meet the criteria for a diagnosis of major depression. This intervention may provide an opportunity to address a debilitating aspect of TBI and could be implemented concurrently with more traditional forms of treatment, possibly enhancing their success. The next step will involve the execution of multi-site, randomized controlled trials to fully demonstrate the value of the intervention.

Mindfulness-Based Cognitive Therapy Reduces Symptoms of Depression in People With a Traumatic Brain Injury

“…The approach has been consistently effective in preventing relapse in individuals with recurrent depression 16,[18][19][20] and is a recommended therapy for relapse prevention in the United Kingdom. In both studies, we found improvements in health status and depression symptoms, 22,23 which were maintained at 1-year follow-up. 22,23 In the first study, we used a 12-week intervention primarily focused on mindfulnessbased stress reduction.…”

“…17 Individuals are taught, by developing a greater awareness of thoughts and feelings, to decenter from problematic thoughts by viewing them as mental events rather than as accurate reflections of reality. 22,23 In the first study, we used a 12-week intervention primarily focused on mindfulnessbased stress reduction. 21 The potential of mindfulness-based interventions in reducing symptoms of depression, preventing relapse, and the relative cost advantage provided by the group format led us to examine the feasibility and potential effect of a modified MBCT program for individuals with a TBI in 2 pilot studies.…”

Psychological Treatments and Psychotherapies in the Neurorehabilitation of Pain: Evidences and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation

“…In addition, preliminary data support the effectiveness of treatments that involve a combination of biofeedback and virtual reality (Grade of recommendation: GPP) (Shiri et al, 2013 ). Research to support the effect mindfulness-based interventions on post-traumatic headache is still ongoing (Grade of recommendation: GPP) (Bédard et al, 2012 ). Finally, one study supports the use of hypnosis for the treatment of pain in post—concussion syndrome (GPP) (Dilks and Bourassa, 2012 ).…”

Teaching mindfulness meditation to adults with severe speech and physical impairments: An exploratory study

“…MM has also been successfully applied to clinical populations dealing with similar symptoms. An RCT demonstrated positive benefits of meditation in persons with multiple sclerosis (Grossman, et al, 2010), and studies with less rigorous methodologies have shown benefits of meditation in traumatic brain injury (Bedard et al, 2012; Johansson, Bjuhr, & Ronnback, 2012) and stroke (Johansson, et al, 2012; Lawrence, Booth, Mercer, & Crawford, 2013). MM training has also been explored in people with aphasia resulting in improved reaction times in a cognitive task (Orenstein, et al, 2012).…”