Does mindfulness based cognitive therapy prevent relapse of depression?BMJ 2012; 345 doi: http://dx.doi.org/10.1136/bmj.e7194 (Published 09 November 2012) Cite this as: BMJ 2012;345:e7194
- Willem Kuyken, professor1,
- Rebecca Crane, director2,
- Tim Dalgleish, professor3
- 1Mood Disorders Centre, University of Exeter, Exeter EX4 4QG, UK
- 2Centre for Mindfulness Research and Practice, School of Psychology, Bangor University, Bangor LL57 1UT, UK
- 3Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
- Correspondence to: W Kuyken Mood Disorders Centre, University of Exeter, Exeter EX4 4QG, UK
Depression typically runs a relapsing and recurrent course.1 Without ongoing treatment people with recurrent depression have a very high risk of repeated depressive relapses throughout their life, even after successful acute treatment. Major inroads into the substantial health burden attributable to depression could be offset through interventions that prevent depressive relapse among people at high risk of recurrent episodes.2 If the factors that make people vulnerable to depressive relapse can be attenuated, the relapsing course of depression could potentially be broken. Currently, most depression is treated in primary care, and maintenance antidepressants are the mainstay approach to preventing relapse.3 The UK’s National Institute for Health and Clinical Excellence (NICE) recommends that to stay well, people with a history of recurrent depression should continue taking antidepressants for at least two years. However, many patients experience side effects, and some express a preference for psychosocial interventions, which provide long term protection against relapse.4 Mindfulness based cognitive therapy (MBCT)5 was developed as a psychosocial intervention for teaching people with a history of depression the skills to stay well in the long term (see box for a description of MBCT).
Description of mindfulness based cognitive therapy
Mindfulness based cognitive therapy (www.bemindful.co.uk/mbct/about) is a psychosocial, group based, relapse prevention programme for people with a history of depression who wish to learn long term skills for staying well. It combines systematic mindfulness training—meditation exercises targeted at enhancing awareness and developing self compassion—with elements from cognitive behavioural therapy.
MBCT is based on a theoretical premise similar to that on which cognitive behavioural therapy is based, and it uses strategies from that therapy too. However, MBCT helps people to learn that the negative thoughts that can signal the start of a depressive episode are fleeting events in the mind that they can choose to engage with or not. Through …