Date of Award

2020

Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant

Department

Physician Assistant Studies

Abstract

Objective: The objective of this selective EBM review is to determine whether or not mindfulness-based cognitive therapy is effective for preventing relapse of depression in adults.

Study Design: Review of three English-language randomized controlled trials published between 2014 and 2015.

Data Sources: Three randomized controlled trials published in peer-reviewed journals comparing mindfulness-based cognitive therapy to comparable treatment options found via PubMed.

Outcomes measured: Outcome measured was presence or absence of relapse of major depressive episodes in adults determined by the Structured Clinical Interview for DSM-IV.

Results: Kuyken et al. found that there was not a statistically significant difference in the incidence of relapse of depression in a adults between those using MBCT and those on maintenance anti-depressant therapy (p=.43 Lancet. 2015;386(9988):63-73. doi: S0140- 6736(14)62222-4 [pii]). After further analysis, the NNT for this study of 33 indicated a small treatment effect. Similarly, Shallcross et al. again found no difference between groups receiving MBCT and those participating in an active control condition (p=.91 J Consult Clin Psychol. 2015;83(5):964-975. doi: 10.1037/ccp0000050 [doi].). Again, after analysis there was a small treatment effect (NNT=-45). Finally, Williams et al. again showed no significant difference in relapse rates between groups receiving MBCT combined with TAU and those using TAU alone(p=.13 J Consult Clin Psychol. 2014;82(2):275-286. doi: 10.1037/a0035036). However, upon further analysis their treatment effects were found to be the largest of the three studies evaluated in this review (NNT=14).

Conclusion: This review showed that there is no difference between MCBT and control conditions in successful prevention of depressive episodes in adults. It was determined that MBCT is a viable treatment option for those with MDD, but it was not shown to be superior to other know treatment modalities such as antidepressant therapy or psychotherapy.

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