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Mindfulness-based therapy 'prevents depression relapse'

December 7, 2010 - Washington

Mindfulness-based cognitive therapy has the same effect as antidepressant medication for preventing relapse among patients treated for depression, say researchers.

The current standard for preventing relapse is maintenance therapy with a single antidepressant.

"Alternatives to long-term antidepressant monotherapy, especially those that address mood outcomes in a broader context of well-being, may appeal to patients wary of continued intervention," he said.

Zindel V. Segal, of the Centre for Addiction and Mental Health, Toronto, and colleagues studied 160 patients age 18 to 65.

After eight months of treatment, 84 achieved remission. Patients in remission were then randomly assigned to one of three treatment groups: 28 continued taking their medication; 30 had their medication slowly replaced by placebo; and 26 tapered their medication and then received mindfulness-based cognitive behavioural therapy.

In this therapy, patients learn to monitor and observe their thinking patterns when they feel sad, changing automatic reactions associated with depression into opportunities for useful reflection.

"This is accomplished through daily homework exercises featuring (1) guided (taped) awareness exercises directed at increasing moment-by-moment nonjudgmental awareness of bodily sensations, thoughts, and feelings; (2) accepting difficulties with a stance of self-compassion; and (3) developing an 'action plan' composed of strategies for responding to early warning signs of relapse/recurrence," wrote the authors.

During the 18-month follow-up period, relapse occurred among 38 percent of those in the cognitive behavioral therapy group, 46 percent of those in the maintenance medication group and 60 percent of those in the placebo group, making both medication and behavioral therapy effective at preventing relapse.

"For those unwilling or unable to tolerate maintenance antidepressant treatment, mindfulness-based cognitive therapy offers equal protection from relapse during an 18-month period, wrote the authors.

The findings were reported in the Archives of General Psychiatry, one of the JAMA/Archives journals.


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