Relapse/Recurrence Prevention in Major Depressive Disorder: 26-Month Follow-Up of Mindfulness-Based Cognitive Therapy Versus an Active Control
Open accessAbstract
We conducted a 26-month follow-up of a previously reported 12-month study that compared mindfulness-based cognitive therapy (MBCT) to a rigorous active control condition (ACC) for depressive relapse/recurrence prevention and improvements in depressive symptoms and life satisfaction. Participants in remission from major depression were randomized to an 8-week MBCT group (n = 46) or the ACC (n = 46). Outcomes were assessed at baseline; postintervention; and 6, 12, and 26 months. Intention-to-treat analyses indicated no differences between groups for any outcome over the 26-month follow-up. Time to relapse results (MBCT vs. ACC) indicated a hazard ratio = .82, 95% CI [.34, 1.99]. Relapse rates were 47.8% for MBCT and 50.0% for ACC. Piecewise analyses indicated that steeper declines in depressive symptoms in the MBCT vs. the ACC group from postintervention to 12 months were not maintained after 12 months. Both groups experienced a marginally significant rebound of depressive symptoms after 12 months but were still improved at 26 months compared to baseline (b = -4.12, p <= .008). Results for life satisfaction were similar. In sum, over a 26-month follow-up, MBCT was no more effective for preventing depression relapse/recurrence, reducing depressive symptoms, or improving life satisfaction than a rigorous ACC. Based on epidemiological data and evidence from prior depression prevention trials, we discuss the possibility that both MBCT and ACC confer equal therapeutic benefit. Future studies that include treatment as usual (TAU) control conditions are needed to confirm this possibility and to rule out the potential role of time-related effects. Overall findings underscore the importance of comparing MBCT to TAU as well as to ACCs.
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Several studies had multiple follow-up points, varying from 26 to 66 months.
“Several studies had multiple follow-up points, varying from 26 to 66 months [65–72].”
From Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis (2022) · cites this paper as [72]
The >24 months analysis of psychological interventions versus TAU included five studies with 588 patients and an average follow-up of 38.6 months (range 26-66).
“Five studies were included in the meta-analysis for studies with a follow-up duration of more than 24 months, with a total of 588 patients. Three studies in this meta-analysis were follow-ups to studies that were included in the main analysis [66, 68, 72]. The average follow-up period in this group was more than 3 years (38.6 months, range 26 to 66 months).”
From Psychological interventions to prevent relapse in anxiety and depression: A systematic review and meta-analysis (2022) · cites this paper as [72]
The publications by Shallcross et al were sequential long-term follow-up studies of the same group of 92 participants.
“publications by Shallcross et al 25,26 were sequential longterm follow-up studies of the same group of 92 participants.”
From Mindfulness-based cognitive therapy for prevention and time to depressive relapse: Systematic review and network meta-analysis (2021) · cites this paper as [26]
Only one of the RCTs clearly reports in the discussion that booster sessions were not provided.
“Only one of the RCTs clearly reports in the discussion that booster sessions were not provided.26”
From Mindfulness-based cognitive therapy for prevention and time to depressive relapse: Systematic review and network meta-analysis (2021) · cites this paper as [26]
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- Kuyken W Byford S Taylor RS Watkins E Holden E White K Teasdale JD 2008 Mindfulness-based cognitive therapy to prevent relapse in recurrent depression Journal of Consulting and Clinical Psychology 76 6 966 978 10.1037/a0013786 19045965 · DOI · Paper page
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- Authors
- Shallcross, A. J., Willroth, E. C., Fisher, A., Dimidjian, S., Gross, J. J., Visvanathan, P. D., & Mauss, I. B.
- Affiliations
- New York University (US)
- University of California, Berkeley (US)
- University of Colorado Boulder (US)
- Stanford University (US)
- Corresponding author
- Shallcross, Amanda J.
- ORCID
- Venue
- Behavior Therapy
- Publisher
- Elsevier BV
- Published
- 2018-09
- Volume
- 49
- Issue
- 5
- Pages
- 836-849
- ISSN
- 0005-7894 (ISSN-L)
- PMC
- PMC6112178
- OpenAlex
- W2791650420
- Cited by
- 31
- References
- 55
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 3 · 2023: 1 · 2022: 4 · 2021: 5 · 2020: 9 · 2019: 2
- FWCI
- 4.70
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.elsevier.com/tdm/userlicense/1.0/ (tdm)
- www.elsevier.com/legal/tdmrep-license (tdm)
- www.elsevier.com/open-access/userlicense/1.0/ (am, 356 d)
- doi.org/10.15223/policy-017 (stm-asf)
- doi.org/10.15223/policy-037 (stm-asf)
- doi.org/10.15223/policy-012 (stm-asf)
- doi.org/10.15223/policy-029 (stm-asf)
- doi.org/10.15223/policy-004 (stm-asf)
- Locations
- Behavior Therapy (acceptedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Center for Complementary and Integrative Health (F32AT004879)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- mindfulness-based cognitive therapy, major depressive disorder, relapse prevention, recurrence prevention, active control, long-term follow-up, depressive symptoms, life satisfaction, remission, maintenance of treatment effects
- MeSH terms
- Adult, Chronic Disease, Depressive Disorder, Major, Major Depressive Disorder, Female, Follow-Up Studies, Humans, Male, Middle Aged, Psychotherapy, Group, Recurrence, Time Factors, Cognitive Behavioral Therapy, Treatment Outcome, Secondary Prevention, Young Adult, Mindfulness
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